采用综合措施及分期修复方法修复髌腱部复合组织缺损

Take comprehensive measures and staged repair strategy to recover the soft tissue defect of the patellar tendon

目的报道一种外伤性髌腱部复合组织缺损采用显微外科技术分期进行创面修复和功能重建的步骤及方法。方法髌腱部创面一期急诊清创,用负压封闭引流技术封闭创面,控制创面炎症后游离股前外侧皮瓣吻合腓肠内侧血管修复髌腱部创面,3个月后应用腓肠肌内侧头肌腱前移重建髌韧带。结果髌腱部创面行游离股前外侧皮瓣修复术后均一期愈合,二期用腓肠肌内侧头肌腱前移修复髌韧带,膝关节伸直功能恢复满意,无髌腱再断裂并发症。结论采用综合措施及分期修复方法可以完成外伤性髌腱部复合组织缺损的修复重建,术式操作简单、再造髌腱外形结构接近正常,实用性强,为髌腱部复合组织缺损修复提供了一种良好的方法。

Objective To introduce a method of staged wound repair and functional reconstruction for traumatic composite tis -sue defects of the patellar tendon,using microsurgical techniques.Methods For the first stage,the vacuum sealing drainage （VSD） was performed at the wound surface to control the inflammation of the wound ,following the emergency debridement .And then to dissoci-ate anterolateral thigh flap anastomosis medial sural vascular to repair the wound of patellar tendon .After three months ,the ligamentum patella was reconstructed by advancing the muscle tendon of gastrocnemius medial head .Results The wounds of the patellar tendon healed by first intention after the repair of dissociating anterolateral skin flap .After advancing the muscle tendon of gastrocnemius medi-al head to repair the ligamentum patellae ,the straighten function of the knee joint recovered well ,without palindromic rapture .Conclu-sion The traumatic composite tissue defects of the patellar tendon can be reconstructed by comprehensive measures and staged repair . The surgery is simple,and the structure of the reconstructed patellar tendon is close to normal ,with strong practicability .Therefore,this method provides a good choice for the repair of composite tissue defects of the patellar tendon .