小腿大面积皮肤撕脱伤并胫腓骨骨折62例分析

我院自１９９６．４～２０００．６，共收治６２例小腿皮肤广泛严重撕脱伤合并胫腓骨骨折的患者，经彻底清创，保留存活撕脱皮肤，网状皮片原位缝合或游离植皮加转移皮瓣修复创面，选择适当的固定治疗骨折，疗效满意，报告如下。资料与方法１．一般资料：本组６２例。男性３８例，女性２４例，年龄１２～６７岁。其中：车祸致伤４０例，砸伤及压轧伤１８例，机器绞绊伤４例。小腿撕脱范围：整段９例，小腿上段１７例，下段３６例，其中合并大腿、双腿伤４例。顺行皮肤撕脱３５例；逆行皮肤撕脱和套状皮肤撕脱１５例，合并广泛软组织血管神经…     

骨穿针悬吊患肢治疗下肢大面积撕脱伤

１９９４年４月以来，我们采用患肢骨穿针悬吊的方法治疗下肢大面积撕脱伤１５例，效果良好，报告如下。临床资料男４例，女１１例；年龄１６～５０岁。１３例为交通事故伤，２例为石料压伤。自腹股沟以下至踝部皮肤全部撕脱２例，小腿及大腿大部分撕脱４例，小腿、大腿部分及足跟部外侧撕脱１例，小腿大部分、足跟及足跖部撕脱３例，小腿后外侧、足跖部外侧撕脱２例，小腿及足跟部撕脱３例。合并出血性休克７例，合并同侧股骨或胫腓骨骨折２例，合并对侧股骨骨折１例。合并同侧胫腓骨骨折和／或踝关节脱位２例。治疗方法１．悬吊架结构：悬…     

儿童肢体大面积皮肤撕脱伤的治疗

肢体大面积皮肤撕脱伤临床多见 ,发生于儿童者亦不少见。正确的处理是预防感染和皮肤坏死的关键 ,我科采用彻底清创 ,不断蒂原位再植的方法治疗 4例 ,效果满意。临床资料一、一般资料　本组 4例 ,男 3例 ,女 1例 ,年龄 4～ 12岁 ,车祸伤 3例 ,跌落伤 1例。 4例均为下肢皮肤撕脱伤 ,近自大腿根部 ,远至踝上沿内侧裂开后向外侧撕脱 ,撕脱皮肤占肢体长70 %～ 85 % ,占肢体周径 5 0 %～ 70 % ,均合并创伤性休克 ,未合并肌肉、肌腱、血管、神经及骨关节损伤。二、治疗方法　待休克基本纠正后 ,在全麻下手术 ,用肥皂水反复刷洗肢体及撕脱皮肤多次 …     

大面积头皮撕脱伤五例

近年来 ,我院收治 5例女性大面积头皮撕脱伤患者 ,分别采用吻合头皮血管的原位再植及中厚皮片移植修复 ,获得较满意效果 ,报告如下。1　临床资料1.1　一般资料本组 5例 ,均为女性。年龄 18～ 45岁。入院时间为伤后3小时内 3例 ,2 0天及 8个月各 1例。致伤原因均为发辫卷入机器所致。头皮完全撕脱 4例 ,其中 2例左耳廓大部分撕脱 ;另 1例枕部遗留 7cm× 3cm头皮 ,枕动脉血管蒂完好。头皮撕脱范围均从前额至枕外粗隆处 ,包括双侧颞肌筋膜。伤后 3小时内入院的 3例中 2例头皮基本完整 ,无明显挫伤 ,1例撕脱头皮污染较重 ,有血管撕裂 ,合并 10 c…     

小腿大面积皮肤撕脱伤合并胫腓骨骨折

本院自1996年4月至2000年6月,共收治62例小腿皮肤大面积撕脱伤合并胫腓骨骨折的患者,经彻底清创,保留存活撕脱皮肤,网状皮片原位缝合或游离植皮加转移皮瓣修复创面,选择适当的固定治疗骨折,疗效满意。报告如下。1临床资料1.1一般资料:本组62例,男性38例,女性24例;年龄12～67岁。车祸致伤40例,砸伤及压轧伤18例,机器绞拌伤4例。小腿撕脱范围:整段9例,小腿上段17例,下段36例,其中合并大腿、双腿4例。顺行皮肤撕脱35例;逆行皮肤撕脱和套状皮肤撕脱15例;合并广泛软组织血管神经损伤8例。1.2治疗1.2.1创面的处理,对皮肤撕脱广泛合并休克的患者,先…     

下肢大面积皮肤撕脱伤的治疗

下肢大面积皮肤撕脱伤在交通事故多见,最常见的是汽车碾压伤,创伤多比较严重,常常合并有大血管、神经及骨关节的损伤;原则上要求早期彻底清创,尽早处理多发伤,争取Ⅰ期创面覆盖.本院自1995年至2001年,共收治22例下肢大面积皮肤撕脱伤患者,总结如下.     

肢体大面积皮肤撕脱伤34例分析

目的：通过34例肢体大面积皮肤撕脱伤的临床分析,讨论全厚筛状皮片的临床应用,方法：对34例肢体大面积撕脱伤用全厚筛状皮片修复及术后随访进行分析。结果：32例全部存活,2例部分坏死,随访6个月至4年,除2例因软组织床损伤严重,造成部分功能丧失外,其余均恢复良好,结论：全厚筛状皮片是治疗大面积皮肤撕脱伤的较理想的方法之一,值得推广应用。     

大面积皮肤撕脱伤1例报告

患者 ,某女 ,30岁。因热滚轴挤压右上肢伴皮肤缺失 4h入院。体温 37 6℃ ,脉搏 113次 /min ,呼吸 2 3次 /min ,血压 80 / 6 0mmHg ,神志清 ,表情痛苦 ,面色苍白 ,四肢冰冷。右前臂和右上臂皮肤撕脱并缺失 ,深筋膜暴露 ,部分肌肉、肌腱断裂 ,右桡骨上端约 2cm× 2cm外露 ,创面色泽灰暗 ,有渗血。拍片示右尺骨下端骨折 ,无移位。入院诊断 :右上肢热压伤合并大面积皮肤撕脱 ;低血容量性休克 ;右尺骨下端不完全骨折。入院后立即建立两路输液通道 ,补充水、电解质和新鲜全血治疗休克。同时 ,应用双氧水和生理盐水反复冲洗创面 ,清除污染物。修剪…     

小腿挤压伤伴撕脱伤15例治疗分析

肢体挤压伤多伴有骨关节等损伤;撕脱伤多为皮肤撕脱伤,较重者含肌肉等深部组织损伤。我科自2009年3月-2010年8月共收治15例小腿挤压伤伴撕脱伤患者,采取自体皮肤反削回植、异种皮覆盖Ⅱ期植皮或知名血管皮瓣转移、单纯清创缝合等方法修复创面,总体效果满意,报告如下。     

提高大面积皮肤撕脱伤的诊治水平

提高大面积皮肤撕脱伤的诊治水平侯春林随着现代交通的发展和工业机械比的普及，四肢大面积皮肤撕脱伤，特别是手、足等部位的脱套伤有增无减，治疗也从单纯创面修复，上升到怎样在一期闭合创面的同时争取满意的外观及功能。近十年有关皮肤撕脱伤的处理积累了丰富的经验，...     

Complete avulsion of ureter caused by abdominal blunt injury: a case report

A 21-year-old woman who had been injured in a traffic accident appeared with abdominal pain and macroscopic hematuria. Computed tomography (CT) performed 6 hours after the injury showed extravasation of contrast medium in the right retroperitoneal space. Retrograde pyelography (RP) showed the interruption of right ureter at the site of ureteropelvic junction. We performed an abdominal operation 15 hours after the injury under the diagnosis of right ureteral avulsion. We observed a completely separated right ureter at the ureteropelvic junction, and performed an end to end anastomosis. The patient was discharged three weeks after surgery, and has not had any problems for three years.     

Treatment of an unusual trans-scaphoid perilunate avulsion fracture dislocation: a case report

We describe an unusual case of trans-scaphoid perilunate injury where the proximal half of the scaphoid avulsed from all attaching ligaments and extruded into the forearm. Treatment involved anatomic reduction and internal fixation of the fracture, scapholunate (SL) ligament repair, temporary K-wire fixation, and prolonged immobilization. At 19-month follow-up, the fracture healed, SL ligament remained intact, and the patient recovered much of his hand function.     

Salvage of a leg avulsion injury by vacuum negative pressure therapy: a case report

We present the case of a 51-year-old woman who suffered an avulsion injury of the right leg in a car accident. In a first time, the simple suture with tiny debridement of the flaps is a failure and lead to a nearly complete necrosis. In a second time, a total avulsion of the devitalized skin is realised and a circumferential VAC system is placed on the wound. Four cycles of vacuum therapy and twelve days later, a split-thickness skin mesh-graft is applied on the leg. This one has a very good take and allows the patient to stand up one month after the initial accident. This example underlines the role of cleaning and pro-budding of the negative therapy after the salvage of a leg avulsion.     

Complete femoral artery and vein avulsion from a hyperextension injury: a case report and literature review

Blunt peripheral extremity vascular injuries are much less frequent than those of penetrating injuries, especially in the absence of significant musculoskeletal trauma. We present an unusual case of complete femoral artery and vein avulsion that resulted from a forced hip hyperextension and thigh abduction after slipping when a patient's foot became entrapped in a ladder. The patient presented with an acutely ischemic right lower extremity 8 hr postinjury, which necessitated immediate surgical exploration, temporary intravascular shunting, interposition grafting, and prophylactic fasciotomy. To our knowledge, this is the first such mechanism to be reported resulting in complete transection of both femoral artery and vein. We review the mechanism of injury and management.     

Simultaneous three-flap reconstruction of extensive hand and finger degloving injury: case report

Connecting the two areas of the hand and digits are the interdigital web spaces that serve as a transition zone and maintain a specific shape and architecture that facilitates the unique patterns of human prehension. In reconstructing a degloving injury that involves the fingers, hand, and interdigital webs, consideration must be given to the function of each of these three regions. The authors present a case report illustrating their management of an extensive degloving injury of the hand and fingers.     

Surgical repair of a traumatic latissimus dorsi avulsion: a case report

We report a case of traumatic avulsion of the latissimus dorsi tendon in a professional body-builder. The injury was repaired by reattachment of the avulsed tendon. This procedure is quite challenging in a well-muscled individual and requires a detailed understanding of the anatomy of the axilla.