血管襻骨膜内组合腓骨同蒂皮瓣移植修复骨与皮肤缺损

目的 探讨下肢粗骨长段缺损与皮肤缺损同时修复的可行方法。方法 将腓血管制成1个或2个血管襻，该血管襻携带皮瓣，再将多段腓骨于骨膜内组合在一起，他成为一个骨膜包裹的粗骨修复骨与皮肤缺损。有丰富血运的骨膜，其骨膜下新生骨活跃，该新生骨充填骨膜内与腓骨段间隙、包绕腓骨，使移植腓骨增粗。结果 临床应用5例，所携带的皮瓣血运良好，伤口一期愈合。1年后骨折愈合，2年后移植骨增粗，能负重行走，移植骨无骨折。供腓骨侧踝关节稳定．伸屈范围正常，功能恢复正常，结论 血管襻骨膜内组合腓骨同蒂皮瓣移植是修复粗骨与皮肤缺损的一种可行方法。

Repairing long-bone and skin defects by transplanting combined fibula segments with a periosteal vaso-nasa wraparound incoprating the overlying skin nourished with the consistent vascular pedicle

Objective To explore the ways of repairing the large long-bone and skin defects as single stage procedures. Methods Five clinic cases were studied, firstly, the arteriae fibularis were restructuered into one or two vaso-nasa which nourished the related fibula segments and the overlying skin, then, binding all of the fibula segments and turn it into a bulky bone with a periosteal vaso-nasa wraparound. The graft was rich in blood supply so osteogenesis activity was vigorous under the periostum, the interspace in the graft soon disappear and the graft increased in diameter gradually. Results All of the harvested skin flaps survived and the wound healed on schedule, besides, the involved fractures were union 1 year later and the grafts were strong enough for weight-bearing and walking 2 year later, Neither fracture occur nor morbidity was created at the donor site, No problem was caused at the ankle. Conclusions It's appropriate way to repair large long-bone and skin defects with a vascularized fibula segments complex transfer incorporationg the overlying skin that was supplied via the same peroneal vessel pedicle.