部分腹直肌肌瓣加皮片移植修复下肢骨折后骨或钢板外露

Soft-tissue repair of the bone or plate exposure after legs fracture with partial reclus aladomtuis muscle flap plus skin graft

目的:探讨游离部分腹直肌肌瓣加皮片移植修复下肢骨折后骨或钢板外露的方法及疗效。方法:2009年10月-2010年12月,笔者单位应用游离部分腹直肌肌瓣加皮片移植修复下肢骨折后骨或钢板外露患者共7例,其中胫骨开放性骨折术后骨质外露4例,胫骨骨折术后钢板外露2例,腓骨骨折术后钢板外露1例。结果:术后除1例植皮部分坏死换药后创面愈合外,其余移植肌瓣及植皮全部成活,术后外形及功能良好,患者均较满意。结论:游离部分腹直肌肌瓣加皮片移植修复下肢骨折后骨或钢板外露具有血供丰富、抗感染力强和顺应性好,术后外形美观等优点,且供区损伤小,只取部分腹直肌,保留了腹直肌的大部分功能,是修复下肢骨或钢板外露,尤其是伴骨髓炎或感染创面的理想方法。

Objective To study the method and effect of free partial rectus abdominis muscle flaps plus skin graft in repairing the bone or plate exposure after legs fracture.Methods Seven cases from October 2009 to December 2010 included 4cases of bone exposure after legs fracture,2cases of plate exposure after tibia fracture surgery and 1cases of plate exposure after fibula fracture surgery,all which were repaired by partial rectus abdominis muscle flap plus skin graft.Results All rectus abdominis muscle flaps and skin graft survived with good appearances and functions except 1 case whose skin graft partial necrosis and the wound healed after dressing treatment.Conclusion Free partial rectus abdominis muscle flap is a proper option for repair of the bone or plate exposure after legs fracture.It has the advantages of abundant blood supply,strong anti-infection ability,good compliance and satisfied appearance.