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LISS接骨板外置联合皮瓣治疗伴软组织缺损胫骨远端开放性骨折的效果

ISSN号：1674-1455
期刊名称：《法治研究》
时间：0
分类：R687[医药卫生—骨科学;医药卫生—临床医学;医药卫生—外科学]
作者机构：[1]宁夏人民医院手足和重建显微外科,宁夏银川750002, [2]西北民族大学第一临床医学院,宁夏银川750002
相关基金：中央高校基本科研业务费专项资金项目(201531920150052);宁夏自然科学基金资助项目(NZ13199);宁夏卫计委重点科研课题立项(2015-NW-003);宁夏卫生厅重点科研课题项目(2013013);宁夏科技支撑对外科技合作项目(201514)

作者：黄永禄[1], 赵飞[1,2], 丁冬[1], 巩凡[1], 李晓亮[1], 杨子洋[1], 姚占川[2], 马建明[1], 沈军[1]

关键词：胫骨骨折, 开放性骨折, LISS接骨板, 外置, 皮瓣, 软组织缺损, Tibial fractures, Open fractures, Liss bone plate, External fixators, Flap, Sofi tissue defect

中文摘要：

目的探讨LISS接骨板外置联合小腿带蒂皮瓣或游离皮瓣治疗伴软组织缺损胫骨远端开放性骨折的临床效果。方法回顾性分析11例伴软组织缺损的胫骨远端开放性骨折患者的资料,依据Gustilo分型,均为GustiloⅡ~Ⅲ型骨折。采用有限切开复位、LISS接骨板外置固定胫骨骨折,多次清创软组织感染控制后采用带蒂转移皮瓣或游离皮瓣覆盖创面。结果术后11例患者均获随访,随访时间4~30个月,平均11.4个月。软组织缺损及感染创面均获得愈合,平均愈合时间5周;胫骨远端骨折均获得骨性愈合,平均愈合时间27周。按照Johner-Wruhs方法进行功能评价,其中优10例,良1例,优良率100%。结论 LISS接骨板外置联合小腿带蒂皮瓣或游离皮瓣治疗伴软组织缺损的胫骨远端开放性粉碎性骨折效果良好,微创复位技术及钢板外置保护骨折端血运、长跨度、少螺钉锁定板固定和创面皮瓣及时覆盖是获得良好疗效的关键。

英文摘要：

Objective To investigate the clinical effect of external Liss bone plate combining with leg pedicle flap or free flap in treating distal tibial fractures with soft tissue defect. Methods 11 patients with distal tibia fracture with soft tissue defect were admitted and were analyzed retrospectively. All the patients were classificated according to the Gustilo fracture. They were Gustilo Ⅱ -Ⅲ fractures. The limited open reduction,fixed tibia fractures with external Liss bone plate,repeated debridement and covering the wound with flap were adopted to treat the soft tissue defect and wound infection. Results 11 patients were followed up for 4 months to 30 months with an average of 11.4 months. The soft tissue defect and the wound infection were all healed and the average healing time was five weeks. The distal tibia fractures showed bone healing with an average healing time of 27 weeks. Johner - Wruhs method was used to conduct functional assessment,in which 10 eases were excellent,l case were good and the rate was 100%. Conclusion The curative effect of external Liss bone plate combining with flap in treating distal tibia open fracture with soft tissue defect is satisfactory. The reasons include the fracture blood supply protected by the limited open, long span, less screw locking plate fixation and timely flap coverage wound.

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