摘要
目的探讨应用显微外科方法治疗交通伤致小腿严重开放性损伤的合理方式。方法对交通伤小腿严重开放性损伤(ⅢB、ⅢC型)的73例患者,早期彻底清创,重建肢体血运,选择外固定支架固定骨折,尽早应用各种皮瓣、肌皮瓣或骨皮瓣修复小腿单纯或复合组织缺损。结果所有病例肢体得以保存,4例皮瓣远端1 cm处部分坏死,经换药或植皮愈合,其余全部成活,创面修复满意,16例骨缺损修复成功。随访6个月至5年,受伤肢体功能大部分恢复,外形满意。结论针对交通伤致小腿严重开放性损伤,采用早期彻底清创、重建肢体血运、合理固定骨折,尽早修复皮肤、软组织或骨缺损,临床疗效满意,大大减少了小腿截肢率和并发症的发生。
Objective To investigate the effective methods of the microsurgical treatment for severe open leg injury by traffic trauma. Methods 73 cases of severe open leg injury （ Ⅲ B and Ⅲ C type） induced by traffic accident were treated by complete debridement, body blood rebuild, external fracture fixation and surgical flaps （myoeutaneous flap and skeletal flap） in order to repair the single or compound injury. Results All limbs of the patients were survived after the surgery. Four cases occurred partial necroses in the remote part of the flap and being healed by changing surgical dressing or performing skin graft, and all the other flaps were survived. Sixteen eases of bone defect were repaired successfully. After followed up for 6 months to 5 years the satisfactory appearance and function recovery were achieved. Conclusion Complete drbridement, body blood rebuild, proper external faracture fixation and repair of skin, soft tissue and bone defect at early stage can achieve satisfactory clinical efficacy and markedly reduces the deformity rates and complications.
出处
《局解手术学杂志》
2012年第4期355-357,共3页
Journal of Regional Anatomy and Operative Surgery
基金
安徽省科技计划课题资助项目(10020503085)
关键词
交通伤
骨折
外科皮瓣
显微外科
traffic injury
fracture
surgical flap
microsurgery
