皮瓣联合外固定架治疗爆炸伤性胫骨骨折伴软组织缺损

Flap and external fixator in the treatment of explosive fracture of tibia associated with soft tissue defect

目的探讨爆炸伤所致小腿软组织缺损伴有胫骨折或骨缺损的有效治疗方法。方法对106例爆炸伤性胫腓骨骨折伴有大面积软组织缺损的患者,采用外固定架固定骨折,游离皮瓣、骨皮瓣移植、腓肠神经营养血管皮瓣、筋膜蒂皮瓣及腓肠肌内外、侧头肌皮瓣转位等方法治疗。结果除1例骨髓炎外,全部患者小腿创面愈合,采用单臂多功能外固定架69例;半环架固定37例,骨折愈合时间为10～24个月。结论外固定架联合皮瓣是治疗爆炸伤性小腿大面积软组织缺损伴有骨折的良好方法 。

Objective To explore effective therapy of explosive fracture of tibia associated with soft tissue and bone defect. Method For the 106 cases of above disease, external fixator and free flap, skeletal flap, sural neurofasciocutaneous flap, fascio-cutaneous flap, gastrocnemius flap were used to repair above defect. Results All the cases healed except for one osteomyelitiss they were subjectes to unilateral multifunctional external fixator in 69 cases, half-ring external fixator in 37 cases; union of fracture required 10-24 months. Conclusion Flap and external fixator is feasible for explosive injury of fracture of tibia associated with soft tissue defect.