支架外固定联合局部转移皮瓣修复伴皮肤软组织缺损胫腓骨开放骨折

Application of External Fixation Combined with Local Flap in Repairing Open Tibia or Tibia and Fibula Fractures with Skin and Soft tissue Defects

目的:分析支架外固定联合局部转移皮瓣在修复伴皮肤缺损胫腓骨开放骨折中的应用。方法:选择胫骨或胫腓骨开放骨折伴皮肤缺损患者61例,分为观察组42例,对照组19例。观察组急诊清创、支架外固定骨折,一期或二期局部转移皮瓣修复皮肤缺损。对照组急诊清创、骨折内固定后直接缝合撕裂的皮肤。结果:观察组39例骨折达到临床愈合标准,2例瘢痕愈合,1例出现感染。对照组11例骨折达到临床愈合标准,8例发生皮肤及软组织缺血、坏死。结论:支架外固定联合局部转移皮瓣手术修复胫腓骨开放骨折伴皮肤软组织缺损疗效确切,值得临床推广。

Objective：To explore the application of external fixation combined with local flap in repairing open tibia or tibia and fibula fractures with skin and soft tissue defects.Methods：61 patients suffered to open tibia and fibula fractures with skin and soft tissue defects which could not be sutured directly were divided into observe group（n=42） and control group（n=19）.Patients in observe group were given emergency debridement and external fixation,and repaired with local flap at the same time or for a second operation.Patients in control group were given emergency debridement and internal fixation direct suture.Results：39 patients in observe group accorded with clinical healing standard.2 patients were scar healing,1 patients had infection.11 patients in control group accorded with clinical healing standard,8 patients suffered ischemia and necrosis.Conclusions：The clinical efficacy of external fixation combined with local flap in repairing open tibia and fibula fractures with skin and soft tissue defects is definite and is worthy of clinical application.