有血运组织瓣与外固定器在手外科修复中的应用

Application of repairing defection by using vascular tissue flap with external fixators in hand surgery

目的报道有血运组织瓣移植在手部修复术中联合应用外固定器固定骨、关节术的临床效果。方法选择手、前臂部位由于骨、关节合并软组织、皮肤缺损病例９例，应用有血运组织瓣移植，包括骨皮瓣、骨关节皮瓣移植修复手或前臂复合组织缺损，同时采用Ａ－Ｏ外固定支架或微型支架行骨外固定，以保持非损伤关节的活动，加速骨质愈合。结果治疗手部骨、关节缺损愈合良好，皮瓣全部成活，术后１０～１６周拆除外固定器，手部功能恢复满意。结论该方法对手部及前臂复合组织缺损的修复疗效明显，并具有骨折固定可靠，移植骨质髓腔损伤小，手、腕关节得以早期训练。

Objective The purpose is to report the clinical result of repairing defection in hand surgery by using both the vascular tissue flap and external fixators. Methods The vascular tissue flap including bone flap and joint flap to repair the complex defection (soft tissue, bones and joints) in hand and forearm were applied in 9 cases. At the same time in surgery,injured bones and joints were fixed by A-O and mini external fixators in order to keep the non-injured joint actively and accelerate the cure of bones. Result All 9 cases were applied successfully with the all transplanted tissue survived. Pulling about the external fixator about 10- 12 weeks after surgery showed bone union and the f unction of hand recovered satisfactorily' Conclusion it is a reliable method for repairing the complex tissue defection in hand and forearm by combining external fixation of traumarology and microsugery technique. And it is also characterized by a minor injury in transplanted bones,early exercise for joints,flap circulation observed conveniently,and nursing easily.