腘动脉损伤延迟后的保肢治疗

目的 提供一种能提高Guo动脉损伤延迟后的保肢治疗方法。方法 从1990年起，在常规骨内固定和血管吻合等治疗基础上，经小腿前外侧入路，彻底切除缺血坏死肌肉，一期缝合皮肤和踝关节或足三关节融合方法，治疗21例时间超过12小时的Guo动脉损伤患者。结果 术后切口I期愈合13例，Ⅱ期愈合5例，Ⅲ期愈合1例；保肢成功19例，2例截肢，截肢率为9．5％。随访2－4年，平均2．9年，存活的肢体均行足踝关节功能位融合，恢复了大部分行走功能。结论 彻底切除小腿缺血坏死的肌肉，一期缝合皮肤是治疗Guo动脉损伤延迟后保肢的一种较理想的补救方法。

SALVAGE OF LOWER LIMB WITH LONG-TIME INJURY OF POPLITEAL ARTERY

Objective To evaluate the rate of salvage of lower limb with long time injury of popliteal artery. Methods Twenty one patients with injury of popliteal artery were treated. The interval between injury and repair of artery ranged from 12hrs to 48 hrs. The essences of operation were thorough debridement of the ischemic and necrotic muscles, primary suture of wound, and repair of popliteal artery on the basis of reduction and fixation of fracture. Results The limb salvage were achieved in 19 cases. The saved limbs could fulfill the basic function of walk. Conclusion Thorough debridement of ischemic and necrotic muscle and primary suture of wound were reasonable methods which could treat long time injury of popliteal artery without amputation.