前臂严重复合组织缺损的急诊修复与一期功能重建

目的 报道游离组织瓣移植与一期功能重建急诊修复前臂严重复合组织缺损的疗效，方法 1994年3月至2003年8月，采用吻合血管的游离皮瓣移植、游离皮瓣与游离腓骨瓣移植或游离腓骨皮瓣移植，同时一期功能重建急诊修复4例前臂严重复合组织缺损。结果 4例均获得成功，经1～3年（平均1年8个月）的随访，骨支架愈合良好，皮瓣血运、质地、弹性好。拇指均可与手指对指，手部恢复保护性感觉。结论 游离组织瓣移植与一期功能重建手术是急诊修复前臂严重复合组织缺损的理想方法。

Emergency repair of severe complex defect in forearm by transplantation of free flap and functional re construction

Objective To report the outcome of emergency repair of severe complex defect in forearm by transplantation of free flap and simultaneous functional reconstruction. Methods From Mar. 1994 to Aug. 2003, 4 cases with severe complex defect in forearm was repaired by transplantation of free skin flap, free skin flap combined with fibula flap, or fibula osteocutaneous flap in emergency. Simultaneously the flexion and extension function were repaired by muscle transfer and/or tendon grafting, tenonectomy. Results All the cases were successful. Follow-up period ranged from 1 to 3 years postoperatively. The blood-supply, texture and elasticity of transferred flaps were excellent with good bone healing. Opposition of thumb with four fingers was good. Sensory. recovery of the hand was satisfactory. Conclusion Transplantation of free flap combined with simuhaneous functional reconstruction is an ideal method in emergency repair of severe complex defect in forearm.