系列组织重建及组合组织移植修复下肢严重交通伤26例

目的 探讨下肢严重交通伤的治疗方法。方法 下肢严重粉碎性骨折或骨缺损，主要血管神经损伤，大面积皮肤软组织缺损２６例，其中男１７例，女９例；年龄４．５－７１岁。采用显微外科手术，根据伤情及创区污染程度，选择带有骨，肌腱等组织组合皮瓣行Ⅰ期修复或采用分期系列组织重建方式治疗下支严重交通伤。

Series tissues reconstruction and composite tissues transfer in treatment of 26 cases of severe traffic injury of lower extremities

Objective To reconstruct and repair the severely injured lower extremities crushed in traffic accidents using series vascularized composite tissues transfer or incorporated transfer. Methods Twenty-six patients (male 17, female 9) aging from 4.5 to 71 years old, were badly injured in lower extremities, including skeletal comminuted fractures and defects, damages of major vessels and nerves, and large defects of skin and soft tissues. According to the severity and pollution of the injured extremities, we selected vascularized flap transfer incorporated with bone and tendon to reconstruct the defects of mutiple tissues at one stage, or series reconstruction by vascular composite tissues transplantation by stages. Results In the 26 cases their crushed extremities were rescued successfully using the methods mentioned above. The follow-up from 1.7 to 8 years showed that the rate of excellent and good function was 69.2% (18/26). Conclusions The vascular composite tissues transfer and series reconstructation were proved effective and practical for saving severely wounded lower limbs in traffic trauma.