组织瓣移位修复锁骨区创面

TISSUE FLAP TRANSFERRING FOR WOUND REPAIR OF THE CLAVICLE

目的探讨不同组织瓣移位修复锁骨区创面的方法和疗效。方法1994年～2000年先后对3例锁骨骨折内固定后钢板外露、锁骨骨髓炎和放射性锁骨区溃疡合并锁骨骨髓炎患者,分别采用翻转筋膜皮下组织瓣、胸大肌肌(皮)瓣和背阔肌肌皮瓣移位修复,观察其疗效,并在复习文献的基础上对组织瓣修复锁骨区创面的手术适应证及不同术式进行总结。结果3例移位的组织瓣全部成活,均经2个月～7年随访,受区外观满意。锁骨骨折愈合,锁骨骨髓炎及溃疡无复发。结论单纯锁骨区创面可用翻转筋膜皮下组织瓣修复,对合并锁骨骨髓炎者,胸大肌锁骨头旋转肌瓣和背阔肌肌(皮)瓣移位修复更合适。对于锁骨区放射性溃疡无法应用局部组织瓣时,采用背阔肌皮瓣是较为理想的选择。

Objective To investigate the result of tissue flap transferring for wound repair of the clavicle. Methods From 1994 to 2000, 3 patients( 1 with clavicle osteosynthesis, 1 with chronic clavicle osteomyelitis, and 1 with radioactive ulcer in clavicular region accompanied by chronic osteomyelitis of clavicle) were reconstructed with turnover adipofascial flap, myocutaneous flap of pectoris, and myocutaneous flap of latissimus dorsal respectively. The outcome was observed. The operation principles of tissue flaps transferring for wound repair of the clavicle were summarized. Results Follow-ups were done for 2 months to 7 years. All tissue flaps survived well and the wounds in clavicular region were healed well. There was no recurrence of chronic clavicle osteomyelitis. Conclusion Turnover adipofascial flap, myocutaneous flap of pectoris and latissimus dorsal are often used for wound repair of the clavicle. Most of the wounds of the clavicle can be repaired by turnover adipofascial flap. Myocutaneous flap of pectoris and latissimus dorsal are more suitable for wound repair with chronic clavicle osteomyelitis. In the case of radioactive ulcer of the clavicular region, myocutaneous flap of latissimus dorsal transposition is a better alternative for wound repair.