远端蒂腓肠神经营养血管皮瓣联合外固定支架治疗胫骨下段开放性骨折的效果分析

发布时间：2019-05-19 17:30

【摘要】：[目的]探讨远端蒂腓肠神经营养血管皮瓣联合外固定支架治疗胫骨下段开放性骨折伴软组织缺损的临床疗效。[方法]选取本院2012年1月~2014年1月收治的胫骨下段开放性骨折患者18例,所有患者于住院期间均行单臂外固定支架联合II期远端蒂腓肠神经营养血管皮瓣修复的治疗方案。现回顾性分析其临床资料,对治疗过程及要点进行总结。[结果]所有患者手术顺利,术中切取肌皮瓣的皮瓣边缘及肌肉面血供丰富。术后皮瓣均成活,16例患者伤口I期愈合,其余2例皮瓣周围少许坏死,将坏死组织仔细切除后定期换药,均愈合。所有供区植皮均成活,伤口I期愈合。所有患者均获随访,时间12~18个月,平均(14.3±3.9)个月,骨折均愈合,无感染、骨不连等并发症,下肢功能恢复满意,肌皮瓣功能及外观良好。[结论]对于胫骨下段开放性骨折,特别是伴有部分软组织缺损的患者,在外固定支架基础上联合远端蒂腓肠神经营养血管皮瓣效果显著,手术操作简单易行,值得临床推广。
[Abstract]:[objective] to investigate the clinical effect of distal sural neurovascular flap combined with external fixation stent in the treatment of open fracture of lower tibia with soft tissue defect. [methods] from January 2012 to January 2014, 18 patients with open fracture of lower tibia were selected. All patients were treated with single arm external fixation stent combined with II distal pedicled sural neurovascular flap during hospitalization. The clinical data were analyzed retrospectively. the treatment process and key points were summarized. [results] the operation was smooth in all patients, and the margin of myocutaneous flap and the blood supply of muscle and meat were abundant during the operation. After operation, the flap survived, 16 cases healed in stage I, and the other 2 cases had a little necrosis around the flap. After careful resection of the necrotic tissue, all of them healed regularly. All the donor skin grafting survived and the wound healed in stage I. All the patients were followed up for 12 to 18 months, with an average of (14.3 卤3.9) months. The fractures healed, there were no complications such as infection and nonunion, the function of lower extremities was satisfactory, and the function and appearance of myocutaneous flap were good. [conclusion] for patients with open fracture of lower tibia, especially patients with partial soft tissue defects, the effect of external fixation stent combined with distal sural neurovascular flap is remarkable, the operation is simple and feasible, and it is worth popularizing in clinic.
【作者单位】：山东莒县人民医院;江苏省中西医结合医院创伤骨科;
【分类号】：R687.3

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