摘要
目的探讨髂腹股沟皮瓣修复股骨大粗隆部严重骨外露的临床疗效。方法2010年10月-2018年3月,采用带旋髂浅动脉的髂腹股沟皮瓣转移治疗股骨大粗隆部严重骨外露27例。缺损范围:4.5 cm×3.0 cm~13.5 cm×7.5 cm,皮瓣切取范围:5.5 cm×4.0 cm~14.5 cm×8.5 cm。术后患髋予支具制动,抗感染、抗凝、解痉等处理,2周后拆支具行功能康复训练。结果全组27例均获6~48个月随访,平均24个月。术后22例伤口一期愈合,皮瓣完全成活,完全恢复正常行走及工作;4例皮瓣远端部分坏死,经换药及清创后伤口二期愈合,较好地恢复行走及工作;1例皮瓣完全坏死,经局部转移皮瓣及植皮治疗后伤口愈合,因局部瘢痕粘连明显,髋关节屈伸稍限制,轻度跛行步态。结论带旋髂浅动脉的髂腹股沟皮瓣是治疗股骨大粗隆部严重骨外露的理想皮瓣,具有皮瓣切取范围大、解剖位置恒定、操作简单可靠、成活率较高、外观及功能恢复优良等优点,较好地解决了该类创伤治疗的难题。
Objective To discuss the clinical effect of the ilioinguinal flap to repair the severe bone exposure of the great trochanter.Methods We transfered the ilioinguinal flap with the superficial iliac circumflex artery to treat the severe bone exposure of the great trochanter for twenty-seven cases from October 2010 to March 2018.The range of the defect was from 4.5 cm×3.0 cm to 13.5 cm×7.5 cm,and the flap from 5.5 cm×4.0 cm to 14.5 cm×8.5 cm.After operation,the affected hip was treated with brace braking,anti infection,anticoagulation,antispasmodic,etc.after 2 weeks,the brace was removed for functional exercise.Results Twenty-seven cases were followed up for 6-48 months,an average of 24 months.22 cases of postoperative wound got primary healing,the flaps survived completely,and the patients recovered to normal walking and work completely.4 cases of distal flap had necrosis,of which Two wounds healed after dressing and debridement,and the patients recovered walking and work.1 flap had necrosis entirely,but the wound healed by transfering flap and skin graft,because of scar adhesion obviously,the fountion of hip was limited slightly,following the mild limping gait.Conclusion The ilioinguinal flap with superficial circumflex iliac artery is an ideal choice to treat the severe bone exposure of femoral trochanter,which can solve the problem of such trauma with the advantages of big flap,anatomical location constant,simple and reliable operation,high survival rate,and functional recovery with good appearance.
作者
陈佳
匡安银
王戈
张生军
CHEN Jia;KUANG Anyin;WANG Ge(Department of Surgery,Zhongliangshan Street Community Health Service Center in Jiulongpo District of Chongqing,Chongqing,400052,China)
出处
《实用手外科杂志》
2022年第4期500-502,共3页
Journal of Practical Hand Surgery
