下肢严重损伤显微外科修复方法的选择

SELECTION OF MICROSURGERY IN REPAIR OF SEVERE WOUNDED LOWER LIMBS

目的：研究下肢损伤后显微修复方法的最佳选择。方法：对６４４例严重下肢损伤，采用１８种显微外科方法修复。结果：３６４例皮瓣、肌皮瓣均成活，所修复的创面完全愈合；２０４例骨（膜）瓣、骨皮瓣治疗骨缺损、骨折不连接，除８例股骨颈头下型骨折外均愈合。对创伤重、多组血管长段受累、组织缺损范围大，采用对侧胫后血管桥接皮瓣移植修复获得较好效果。结论：对于下肢严重的损伤，采用显微外科方法进行修复，可获得较好的临床效果。

Objective:To study the best microsurgical method for treating the varied casws se- ere lower limb defect.Methods:644 cases with severe wounded lower limbs have been treated with 18 kins of microsurgical methods. Results:364 cases were treated with skin flaps and musculocutanous flaps . All the flaps survived and surfaces of wound were healed.204 cases with bone defect and nounion were treated with bone flaps and bone skin flaps,all were union except for 8 cases with sub- capital type fracture of neck of femur. Conclusions:The defects of bone, skin and muscle in severe lower limbs could be repaired by microsurgical methods.