摘要
目的 为临床上治疗胫骨中下段骨不连、骨缺损或新鲜粉碎骨折合并软组织缺损提供一种简单而有效的新方法。方法 在 3 5侧经动脉内灌注红色乳胶的下肢标本上 ,解剖观测比目鱼肌的形态和血供特点 ,设计了比目鱼肌内侧半为蒂胫骨骨膜瓣逆行转位的手术方式。结果 比目鱼肌内侧半肌瓣血供主要来源于胫后动脉节段性供应 ,平均每侧 6支 ,胫骨内侧缘肌附着处长( 8.87± 0 .66)cm ,中分宽 ( 1.0 4± 0 .3 7)cm ,可取骨膜瓣面积 ( 9.0± 3 .0 )cm2 ,逆行转位最低旋转点位于内踝突出点上 ( 9.70± 2 .43 )cm。经临床应用 2 0例 ,疗效满意。结论 本术式可一期修复胫骨中下段骨不连、骨缺损或新鲜粉碎骨折并软组织缺损。手术操作简便实用。
Objective To provide a new kind of simple and effective method for repairing the fracture nonunion defect of the middle and distal tibia or the fresh crush fracture accompanied by soft tissue defect.Methods The morphology and blood supply regularity of the soleus were observed on 35 adult lower limb specimens injected with red latex.The reversed transposition of tibial periosteal flap pedicled with medial half of the soleus could be designed.Results On the average,muscle branches of posterior tibial arteries were found to distribute segmentally at the medial half of soleus.Its insertion of medial edge of tibia was (8.87±0.66)cm in length and (1.04±0.37)cm in width at the middle.The available area of muscle periosteal flap was (9.0×3.0)cm 2.The turning point of reversed transposition was (9.70±2.43)cm above the medial malleolus.Satisfactory effects were obtained on 20 patients in clinic.Conclusions The operative way could be designed to repair meanwhile the fracture nonunion defect of middle and distal tibia or the fresh crush fracture accompanied by soft tissue defect.
出处
《临床外科杂志》
2003年第6期413-414,共2页
Journal of Clinical Surgery
