伴有软组织缺损的中足损伤处理

目的探讨伴有软组织缺损的中足损伤手术治疗效果。方法12例伴有软组织缺损的中足损伤患者,急诊清创术后1545 d二期行骨折脱位复位内固定,同时皮瓣游离移植或局部转移行软组织缺损覆盖术。结果移植皮瓣全部成活,其中5例二期行皮瓣削薄术。全部获得随访,时间1225个月。依据美国矫形足踝协会（AOFAS）的中足评分标准对患足术后的功能进行评定,优2例,良5例,可3例,差2例。结论伴有软组织缺损的中足损伤,必须在重视骨折和脱位的同时兼顾到软组织的处理,方能取得满意的疗效。

Treatment of open mid-foot injury with soft tissue defect

Objective To discuss the effects of operative treatment of open mid-foot injury with soft tissue defect.Methods 12 cases of mid-foot injury with soft tissue defect were treated in our department.The debridement was performed at the first-stage,and 0.51.5 months later,internal fixation and a variety of skin flap graft or transfer were finished at the second-stage.Results All the skin flap in the series survived in which 5 cases performed a flap skiving surgery.Sufficient follow-up was obtained in 12 patients,ranging from 12 months to 25 months.Function of the foot was evaluated by using the American Orthopaedic Foot ＆ Ankle Society（AOFAS） mid-foot scoring system.There are 2 excellent,5 good,3 fair and 2 poor.Conclusions To receive a satisfactory result,allover consideration in the management of fracture/dislocation and the soft-tissue injury should be given in treating the mid-foot injury with soft-tissue defect.