膝以下严重开放性创伤的修复

Repair of serious open injury below knee

[目的]研究膝以下严重开放性创伤的修复。[方法]自1995年3月～2005年3月收治膝以下严重开放性损伤153例，Ⅰ期修复106例，Ⅱ期修复47例，7种内固定方法，11种皮瓣修复方法。[结果]153例中随访132例，时间6个月～5年，平均17个月，术后功能优良率85．7％，皮瓣成活率良好。皮瓣局部坏死25例，骨不连4例，慢性感染8例，骨髓炎3例。[结论]改进的腓肠神经营养血管皮瓣和皮瓣桥手术扩大了皮瓣的应用范围，减少了并发症的发生。本研究为膝以下严重开放性损伤的修复提供了良好的方法；熟练的显微外科技术和各种组织瓣的合理应用是修复成功的关键。

[ Objective ] To explore the method ot rehabilitation tor serious open injury Delow Knee. [Method] A total of 193 cases with serious open injury below knee were treated. In which 106 cases were primary repair,47cases were second repair,treated with 7 kinds of internal fixation metbods,11 kinds of flap. [ Result] A fotal of 132 cases were followed up from 6 months to 5 years after operation,the average time was 17 months, the postoperative satisfaction rate was 85.7% , the flap survival rate was good 25 cases with local necrosis,4 cases with non-union,8 cases with chronic infection, 3 cases with osteomyelitis. [ Conclusion] The improvement of the flaps enlarge the application and reduce the complication of the flaps. The study offer a reasonable method to repair serious open injury below knee. The proficiency microsurgical scissors and reasonable application of various tissue flaps was the key to repair the injury successfully.