尺桡骨开放性骨折合并软组织缺损的1期处理

The Abdominal Pedicled Fap or Dorsalis Pedis free Flapreconstruction Primarily for the soft—tissue Defect of Opening Fracture in Ulnar and Radial

目的:探讨尺桡骨开放性骨折合并软组织缺损的处理。方法:受区彻底清创,清除失去活力的组织,拟行游离皮瓣修复者解剖出拟吻合的血管。尽可能以简单而有效的方法固定骨折,再依软组织缺损面积切取腹部带蒂皮瓣或游离足背皮瓣修复,带蒂皮瓣3周后断蒂。结果:应用该方法共处理1l例,7例采用腹部带蒂皮瓣,4例游离足背皮瓣。皮瓣全部成活。结论:腹部带蒂皮瓣可切取面积大,操作简单,安全可靠;足背皮瓣血管蒂恒定、管径粗易吻合且皮下脂肪少耐磨,是肥胖患者的较好供区。

Objective：To provide a restoring way of soft-tissue defect for opening fracture of ulnar and radial in the forearm.Methods：To dissect the radial vessels for use of free flap after debridement of recipient wound and removal of devitalized tissue.Depending on the size of soft-tissue defect of recipient wound,the dorsalis pedis free flap or abdominal pedicled flap was harvested after a simple and effective fixation for fracture.To disconnect the pedicle of the pedicled flap in three weeks of post-operation.Results：Using this method,we treated 11 patients.Among them,7 cases by the abdominal pedicled flap while 4 cases by the dorsalis pedis free flap.All were uneventful postoperatively.Conclusion：The abdominal pedicled flap is Simple,safe and dependent especially for a large soft-tissue defect in forearm while the dorsalis pedis free flap is a better choice for fatty patient because of its constant vascular pedicle and thin skin paddle.