背阔肌肌皮瓣修复上臂复合组织缺损效果观察

Grafting of latissimus dorsi myocutaneous flap for repair of complex tissue defect in the upper limb

目的探讨应用背阔肌肌皮瓣修复上臂复合组织缺损的疗效。方法用带蒂背阔肌肌皮瓣修复上肢皮肤肌肉缺损,并重建肱二头肌和肱三头肌功能。皮瓣切取面积为7-15cm×18-22cm。结果15例皮瓣全部存活,术后随访1-9年。局部外形圆润,饱满,质地柔软,无明显肌萎缩发生,病人屈、伸肘功能恢复。8例肌力恢复至M4,6例恢复到M3,1例为M3-。结论应用背阔肌肌皮瓣修复上臂皮肤、肌肉缺损时,外观及功能恢复满意。

Objective To investigate the treatment outcome of latissimus dorsi myocutaneous flap for repair of complex tissue defect in the upper limb. Methods The pedicled latissimus dorsi myocutaneous flaps was used to cover skin and muscle defects in the upper limb. The functions of biceps and triceps were reconstructed simultaneously. The areas of the flap ranged 7 15 cm × 18 - 22cm. Results All flaps survived successfully in 15 patients. Follow-up for 1- 9 years exhibited that the muscle strength recovered to M4 in 8 patients, M3 in 6 and M3 in 1. The flexion and extension function of the elbow was recovered and no obvious amyotrophy was found. Conclusion Using latissimus dorsi myocutaneous flap to repair skin and muscle defect in the upper limb can achieve a satisfactory appearance and functional recovery.