预防性胫前肌-筋膜瓣转位在并发延迟皮肤坏死的胫骨骨折患者的应用

Preventive transposition of anterior tibial myofascial flaps for tibial fractures with delayed skin necrosis

目的：探讨预防性胫骨前肌-筋膜瓣转位在胫骨骨折合并重度皮肤软组织损伤发生延迟坏死病例中应用的临床疗效。方法对14例合并重度皮肤软组织损伤的胫骨骨折患者行Ⅰ期骨折固定联合预防性胫前肌-筋膜瓣转位术，发生皮肤延迟坏死后予以植皮，观察其伤口愈合情况、随访骨折愈合及并发症情况。结果14例患者伤口均愈合，无感染并发症，随访13例，骨折均愈合，无骨外露、骨髓炎等并发症，1例失访。结论预防性胫前肌-筋膜瓣转位是一种安全、简便、有效的治疗并发延迟皮肤坏死的胫骨骨折的措施。

Objective To discuss the effect of preventive transposition of anterior tibial myofas-cial flaps for tibial fractures complicated with severe skin and soft tissue injuries and delayed necrosis. Methods Fourteen cases of tibial fractures with severe skin and soft tissue injuries were selected for one-stage fixation combined with preventive transposition of anterior tibial myofascial flaps. The skin was cov-ered with grafts followed after the occurrence of delayed necrosis. Wound healing,fracture healing and com-plications were closely observed. Results All wounds got healed without any infective complications. Thir-teen cases were followed up and all fractures healed without bone exposure,osteomyelitis and other compli-cations. One case was lost to follow-up. Conclusion Preventive transposition of anterior tibial myofascial flaps is a safe,simple and effective management for the treatment of tibial fractures with delayed skin nec-rosis and avoidance of related complications.