摘要
目的探讨腓肠肌内侧头肌皮瓣修复老年人胫骨慢性骨髓炎创面的效果。方法对11例胫骨慢性骨髓炎老年患者行系统抗生素治疗后,先清除病灶,二期使用腓肠肌内侧头肌皮瓣填塞、修复骨及软组织缺损,供区缺损创面切取全厚皮片移植。术后指导功能锻炼。结果 11例均获随访,时间6～18(12.2±3.8)个月。术后1周3例皮瓣远端发生干性坏死,2例经换药后愈合,1例未愈,余8例皮瓣均顺利成活。供区植皮均成活。未出现基础疾病加重情况。根据Enneking评分评价疗效:优8例,良2例,差1例;依据AOFAS踝足功能评分标准:优9例,良2例。结论腓肠肌内侧头肌皮瓣修复老年人胫骨慢性骨髓炎创面,符合老年患者人群特点,是有效的治疗方法。
Objective To investigate the effect of using the medial head of gastrocnemius muscle flap for repairing chronic wound of osteomyelitis in the tibia of elderly patients.Methods 11 cases were underwent the treatment.After systemic antibiotic therapy and radical debridement,the plerosis of bone and soft tissues was treated by medial head of gastrocnemius muscle flap.Muscle flap donor site was covered with full-thickness skin graft.Postoperatively,active rehabilitation was necessary.Results All patients were followed up for 6～18（12.2±3.8）months.A week after the operation,3 cases with distal necrosis of the muscle flap,with a single exception,were treated successfully.The other 8 cases were healed without any operative complications.11 cases had no deterioration of basic disease.According to the Enneking scoring system in evaluating efficacy：excellent 8 cases,good 2,poor 1.However,the effect in accordance with AOFAS mid-foot score：excellent 9 cases,good 2 cases.Conclusions The treatment using medial head of gastrocnemius muscle flap is an practical method for chronic osteomyelitis of tibia in elderly patients.
出处
《临床骨科杂志》
2013年第2期162-164,共3页
Journal of Clinical Orthopaedics
关键词
腓肠肌皮瓣
胫骨
慢性骨髓炎
创面
老年人
gastrocnemius muscle flap
tibia
chronic osteomyelitis
wound
aged
