摘要
目的探讨交锁髓内钉与带蒂皮瓣转移治疗小腿严重损伤之疗效。方法对11例合并神经损伤多段开放性小腿骨折,一期行损伤血管神经与骨折修复重建,二期行健侧小腿内侧带蒂皮瓣转移修复骨外露、肌腱外露。结果随访16个月～5年,9例远端血运良好,皮瓣成活,骨折愈合,外观正常,不臃肿,活动尚好。2例自体大隐静脉移植后远端血液供应差,伤口坏死、感染,行截肢术。结论在彻底清创的基础上,采用交锁髓内钉固定、重建多平面严重粉碎性骨折的连续性,采用自体大隐静脉桥接胫前动脉恢复血液供应、二期对侧小腿内侧带蒂皮瓣转移修复,是一种比较理想的方法。
Objective To investigate the effect of interlocking intramedullary nailing and pedicled flap transplantation for severe leg injuries. Methods 11 cases of severe leg injuries were enrolled. In stage Ⅰ , the vascular injuries and fractures were repaired, and in stage Ⅱ , the bone and tendon exposures were covered with pedicled flap transplantation from the opposite legs. Results All eases were followed up for 16 -60 months. 9 flaps survived with good blood flow and apperance, and the fractures healed with good leg functions. 2 flaps necrotized and were infected for poor vascular support with great saphenous transplantation, and underwent amputation. Conclusions With complete debridement, it is an ideal way to treat severe leg injuries with interlocking intramedullarv nailing to restore stability, and with pedicled flap transplantation with great saphenous bridging and anterior tibial artery to repair the soft tissue defects.
出处
《临床骨科杂志》
2005年第5期439-441,共3页
Journal of Clinical Orthopaedics
关键词
骨折
粉碎性
腿损伤
血管神经损伤
交锁髓内钉
外科皮瓣
修复
fractures, comminuted
leg injuries
blood vesssls and nerves injuries
interlocking intramedullarv nail
surgical flaps
repair
