目的:观察腓肠肌岛状穿支肌皮瓣治疗胫骨近端骨髓炎伴骨外露的临床效果。方法:回顾性分析2013年1月至2015年6月在我科收治的15例胫骨近端骨髓炎伴骨外露患者,采用彻底清创、用腓肌岛状穿支肌皮瓣进行修复治疗,皮肤缺损面积为5cmx4cm~8cmx6cm.切取皮辫面积为6cmx5cm-9cmx7cm。术后对皮瓣成活率、并发症、膝踝关节功能、皮瓣外观满意度进行随访观察。结果:本组15例中14例肌皮瓣一期愈合,1例二期愈合,术后随访6~18个月无感染复发病例,膝踝关节功能良好。根据改良ASAMI评分系统评价疗效:优10例,良4例,中1例,差0例。结论:腓肠肌岛状穿支肌皮瓣修复胫骨近端骨髓炎伴骨外露具有良好疗效。
Objective: To observe the clinical curative effects of the medial sural artery perforator island musculocutaneous flap on proximal tibial osteomyelitis combined with bone exposure. Methods: Between Janury 2013 and June 2015, the medial sural artery perforator island musculocutaneous flap were used to reconstruct proximal tibial osteomyelitis combined with bone exposure in 15 patients at our institute. The areas of defect ranged from 5 cmx 4 cm to 8 cmx 7 cm, Flap sizes ranged from 6 cmx 5 cm to 9 cmx 8 cm. The flap survival rate, complication, the function of knee and ankle joint, appearance of satisfaction were followed up. Results: Flaps survived in all patients cases, the muscle flaps in 14 cases healed in phase I and those in 1 cases healed in phase II. There was no recurrence in the follow-up of 6 months to 18 months. There were no stiffness of the joint. According to the modified ASAMI criteria for bone healing, 10 cases were excellent, 4 good, one moderate, zero poor. Conclusion: The medial sural artery perforator island musculocutaneous flao is an effective treatment for oroximal tibial osteomvelitis combined with bone ext~osure.