带监测皮岛的胫前动脉穿支骨膜瓣治疗骨不连的临床应用

The treatment of bone nonunion with perforator periosteal flap with monitoring flap pedicled with the anterior tibial artery

目的 探讨带监测皮岛的胫前动脉穿支骨膜瓣治疗骨不连的临床效果.方法 应用带监测皮岛的胫前动脉穿支骨膜瓣治疗骨不连25例,总结手术方法和操作要点,观察临床效果.结果 术中切取的骨膜瓣大小适宜,监测皮岛血运良好,术后伤口大部分一期愈合,2例皮岛边缘少许坏死,换药后愈合.25例术后随访10～24个月,平均15.1个月,原骨不连处骨痂生长良好,髓腔再通,骨折线在3～6个月消失,骨折愈合后关节功能恢复均较满意.结论 带监测皮岛的胫前动脉穿支骨膜瓣治疗骨不连,手术成功率高,是治疗骨不连的一种有效可行的方法.

Objective To investigate the clinical effect of artery perforator periosteal flap for the treatment of bone nonunion with monitoring flag pedicled of the anterior tibial.Methods 25 cases were treated by with bone nonunion patients with monitoring island skin flap of the anterior tibial artery perforator periosteal flap,summarized the operation method and operation points,and observed the clinical effect.Results The flap size was suitable,the color of monitoring flap was excellent,all incisions healed primarily.2 cases skin edge necrosised and healed after dressing change.All of the 25 cases were followed up for 10～ 24 months,with an average of 15.1 month,the original nonunion bone callus grew well,medullary cavity recanalized,the fracture line was away in 3～6 months,joint functions was satisfactory after fracture healing.Conclusion It is an effective method for treatment of bone nonunion by using the monitoring island skin flap of the anterior tibial artery perforator periosteal flap.