腓动脉骨皮瓣治疗小腿中下段开放伤伴胫骨及软组织缺损

目的探讨应用对侧游离腓动脉骨皮瓣移植治疗大段胫骨及胫前软组织坏死缺损的疗效。方法对因创伤所致大段胫骨及胫前软组织坏死的11例患者,清除坏死骨质及软组织后,行吻合血管的腓动脉骨皮瓣移植重建,包括一例非全周径（外侧2/3周径）的腓动脉骨皮瓣移植。结果结果经6-24个月随访,移植腓骨及皮瓣全部成活,胫骨严重粉碎性骨折均获骨性愈合,无一例截肢,无一例出现慢性骨髓炎,下肢外形及功能恢复满意。结论胫骨大段骨缺损,同时合并软组织缺损的病人,给予对侧带血管蒂的腓骨骨皮瓣移植,仍不失为一种可靠方法。

Treatment of soft tissue defects and severe open comminuted fractures of mid-distal tibia by using vascularized fibular skeletal flaps

Objective To analyze the curative effect of vascularized fibular skeletal flaps from the other side in the treatment of soft tissue defects and severe open comminuted fractures of tibia.Methods A total of 11 patients with severe comminuted fractures of tibia,skin and soft tissue defects were reconstructed by using vascularized fibular skeletal flaps at first stage after thorough debridement.Results During a follow-up period of 6 to 24 months,severe comminuted fractures of tibia were healed.No amputation was needed and no chronic osteomyelitis occurred.The circulation of revascularized limbs was good and the contour and function were restored satisfactorily.Conclusion It is a reliable choice to repair the soft tissue defects and severe open comminuted fractures of tibia by using vascularized fibular skeletal flaps.