Ilizarov技术联合皮瓣即时扩张技术Ⅰ期矫正合并皮肤挛缩的胫骨成角畸形
发布时间：2019-03-25 09:21
【摘要】：目的:探讨采用Ilizarov技术联合皮瓣即时扩张技术Ⅰ期矫正合并皮肤挛缩的胫骨成角畸形的临床疗效及安全性。方法:自2010年1月至2015年1月,采用Ilizarov外固定技术联合挛缩侧皮肤术中即时扩张技术Ⅰ期矫正合并皮肤挛缩的胫骨成角畸形患者30例,男21例,女9例;年龄25~60岁,平均(40.2±5.5)岁。定期复查X线片,去除Ilizarov外固定后采用美国特种外科医院(HSS)评分标准评定膝关节功能,并采用疼痛视觉模拟评分(VAS)评价其疼痛缓解程度。结果:术后所有患者获随访,时间6~35个月,平均22个月。其中29例患者切口均Ⅰ期愈合,1例患者出现切口感染并发骨髓炎,2例患者并发固定钉松动,扩张皮瓣区均无坏死,无神经血管牵拉损伤症状。术后4~7个月去除外固定架,平均(5.2±1.1)个月。矫正成角角度10°~35°,平均(25.5±3.5)°。术后根据HSS评分标准,总分92.5±6.6,其中优25例,良4例,中1例;VAS评分1.2±1.5。结论:采用Ilizarov技术联合皮瓣即时扩张技术能够Ⅰ期矫正合并皮肤挛缩的胫骨成角畸形,带架时间短,无皮肤坏死及神经症状,能够早期负重锻炼并改善患肢功能。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Ilizarov technique combined with immediate expansion of skin flap in the treatment of tibial angular deformity with skin contracture. Methods: from January 2010 to January 2015, 30 patients (21 males and 9 females) with tibial angular deformity were treated with Ilizarov external fixation combined with immediate skin expansion during skin contracture. The mean age was (40.2 卤5.50) years. The function of knee joint was evaluated by (HSS) scoring standard of American Special surgery Hospital and the pain relief degree was evaluated by (VAS) after regular reexamination of X-ray films and removal of Ilizarov external fixation. Results: all patients were followed up for 6 months and 35 months (mean 22 months). There were 29 cases of wound healing, 1 case of incision infection complicated with osteomyelitis, 2 cases of loosening of fixation nail, no necrosis of dilated flap area and no symptoms of neurovascular traction injury. The external fixator was removed 4 months after operation with an average of (5.2 卤1.1) months. The angle of correction ranged from 10 掳to 35 掳, with an average of (25.5 卤3.5) 掳. According to the HSS score, the total score was 92.5 卤6.6, among which 25 cases were excellent, 4 cases were good, 1 case was middle, and the VAS score was 1.2 卤1.5. Conclusion: the technique of Ilizarov combined with immediate expansion of skin flap can correct the angular deformity of tibia with skin contracture in stage 鈪，
本文编号：2446844
[Abstract]:Objective: to investigate the clinical efficacy and safety of Ilizarov technique combined with immediate expansion of skin flap in the treatment of tibial angular deformity with skin contracture. Methods: from January 2010 to January 2015, 30 patients (21 males and 9 females) with tibial angular deformity were treated with Ilizarov external fixation combined with immediate skin expansion during skin contracture. The mean age was (40.2 卤5.50) years. The function of knee joint was evaluated by (HSS) scoring standard of American Special surgery Hospital and the pain relief degree was evaluated by (VAS) after regular reexamination of X-ray films and removal of Ilizarov external fixation. Results: all patients were followed up for 6 months and 35 months (mean 22 months). There were 29 cases of wound healing, 1 case of incision infection complicated with osteomyelitis, 2 cases of loosening of fixation nail, no necrosis of dilated flap area and no symptoms of neurovascular traction injury. The external fixator was removed 4 months after operation with an average of (5.2 卤1.1) months. The angle of correction ranged from 10 掳to 35 掳, with an average of (25.5 卤3.5) 掳. According to the HSS score, the total score was 92.5 卤6.6, among which 25 cases were excellent, 4 cases were good, 1 case was middle, and the VAS score was 1.2 卤1.5. Conclusion: the technique of Ilizarov combined with immediate expansion of skin flap can correct the angular deformity of tibia with skin contracture in stage 鈪，
本文编号：2446844
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