摘要
目的:总结外固定支架复合交腿带蒂皮瓣治疗胫骨粉碎性骨折合并皮肤坏死的临床效果。方法:2006年6月至2011年6月,收治胫骨粉碎性骨折合并皮肤坏死28例,男20例,女8例,年龄20～56岁。其中车祸伤18例,压砸伤8例,坠落伤2例,合并骨折区周围皮肤坏死范围6 cm×3 cm～18 cm×8 cm。以外固定支架或结合少量内固定恢复胫骨稳定性,均采用对侧小腿交腿带蒂皮瓣对坏死创面在彻底清创下进行修复,供区创面采用游离植皮或直接缝合。结果:术后1例皮瓣创缘部分坏死继发感染,经换药处理后创缘Ⅱ期愈合,其余患者皮瓣均成活,供区植皮成活,创面愈合良好。术后患者均获随访,随访时间3个月皮瓣外形满意,质地优良。1例胫骨中下段粉碎性骨折延迟愈合,余患者胫骨骨折于术后3～4个月临床愈合,患肢功能基本恢复,能够部分负重行功能锻炼。结论:外固定支架复合交腿皮瓣是治疗胫骨粉碎性骨折合并皮肤坏死的安全有效方法。
Objective To summarize the clinical effects of external fixator combined with cross-leg flap in the treatment of tibia communicated fracture with skin necrosis.Methods From June 2006 to June 2011,totally 28 cases of tibia communicated fracture with skin necrosis were hospitalized,aged from 20 to 56 years old and included 20 males and 8 females.Of the patients,there were 18 ones from traffic accidents,8 ones from crash injuries and 2 ones from falling injuries,with the scopes of skin necrosis ranging from 6 cm ×3 cm to 18 cm×8 cm.External fixator,or internal fixator in some cases,was used for the stability of the tibia.The cross-leg flap from the contralateral leg was applied to the repair of the wound after debridement,and the wound at the donar area was treated with free skin graft or direct suture.Results One patient suffered from partial necrosis with secondary infection occurred at the edge of the flap,and then underwent delayed healing after dressing change;the remained patients gained satisfactory results for the flaps,donor area and wound.The 3month follow-up proved that all the flaps were satisfactory for their shapes and textures,and that except one patient with delayed healing of communicated fracture,all the cases went through clinical healing 3 to 4 months after the operation,with the affected limbs functioning well and enduring loaded exercise.Conclusion The external fixator combined with cross-leg flap is safe and effective for the treatment of tibia comminuted fracture with skin necrosis.
出处
《医疗卫生装备》
CAS
2013年第7期69-70,共2页
Chinese Medical Equipment Journal
关键词
交腿皮瓣
外固定支架
胫骨粉碎性骨折
皮肤坏死
cross-leg flap
external fixator
tibia communicated fracture
skin necrosis
