采用显微外科技术处理胫骨多平面长骨段粉碎性骨折及其软组织损伤

目的总结采用显微外科技术修复胫骨严重粉碎性骨折及其软组织损伤的经验。方法在彻底清创基础上，采用吻合血管腓骨或腓骨复合组织瓣移植方式，修复胫骨严重粉碎性骨折与神经、血管及其软组织缺损。结果经6～24个月随访，胫骨严重粉碎性骨折均获骨性愈合，重建血管肢端血运良好，修复的神经恢复了肢体的感觉及运动功能；有4个肢体短缩1～3cm，3个踝关节背伸较健侧小10°～15°，但均不影响日常生活与工作。结论采用显微外科技术Ⅰ期或延期处理复杂性胫骨骨折，具有加速骨折愈合，控制感染，降低致残率，免除肢体截除之危险。

Treatment of soft tissue injury and multi-placed communited fracture of tibia by using microsurgery technology

Objectise To analysis the treatment of severe communited fracture and soft tissue injury of tibia. Mehtods Based onhoroughly debriding,severe communited fracture and nerve,blood vessel,soft tissue defect are repaired using vascularized fibular or fibular composite tissue. Result After the following-up of 6～ 24 mouths,severe communited fracture of tibia is unioned,the circulation of revascularized limbs are good, the sensory and motion function are restored. Four limbs are shortened in 1 ～ 3 cm,the dorsal extension rang or ankle joint are 10°～ 15° smaller than contro-lateral limbs,but daily life and work are not influenced. Conclusion The treatment of complicated fracture by microsurgery technology in initial or late stage can accelerate fracture union,Control infection and decrease the danger of disability and limb resecting.