局部带蒂转移皮瓣结合外固定支架技术修复肢体软组织伴大段骨缺损

目的 探讨如何在减少手术创伤的情况下修复肢体软组织伴大段骨组织缺损.方法 回顾分析3例行局部带蒂转移皮瓣结合外固定支架(Ilizarov技术)修复肢体软组织缺损同时伴有大段骨缺损的临床资料,对病人的肢体外形、功能及接受程度进行评价.结果 转移皮瓣3例均成活,骨延长后断端骨性愈合,延长骨段矿化良好,肢体外形及功能恢复满意.结论 与传统的游离皮瓣结合转移骨瓣的治疗方法相比较,带蒂转移皮瓣结合Ilizarov技术的术式难度及创伤较小,所有皮瓣全部成活,局部创面修复后,移植皮瓣弹性及耐磨性良好,感觉存在;延长骨质矿化良好,新生骨质强度良好,可承重;病人对手术方式可以接受,肢体功能恢复表示满意.

Local pedicle flap transfer combined with Ilizarov technique to repair limb soft tissue with large segment of bone defect

Objective To explore how to reduce the surgical trauma in the case of repair of limb soft tissue with large segment of bone defect.Methods We retrospectively analyzed the clinical data of 3 cases of local pedicle flap transfer combined with external fixator frame (Ilizarov technique) to repair limb soft tissue defect accompanied by large segment of bone defect,and evaluated the body shape,function and acceptability of the patient.Results Transfer flaps in 3 cases all survived.Bone union was obtained of fractured ends after bone lengthening.The lengthened sgemental bone was well minaralized and limb shape and function recovered satisfactorily.Conclusions Compared with the traditional treatment of free flap combined with transfer bone flap,the pedicle flap transfer combined with Ilizarov technique is less difficult and less traumatic.All flaps survive.After local wound repair,the elasticity and wear resistance of graft flap are good and sensible.Mineralization of the lengthened bone is good and the strengthen of the new bone is satisfactory with weight capacity.The surgery is acceptable,and the patients are satisfied with the recovery of limb functions.