足前部组织缺损再造修复一些问题的探讨

Problems in reconstruction of compound defects of the forefoot

目的探讨前足骨与软组织损伤及缺损修复与重建的意义、方法及所涉及的相关问题。方法根据前足损伤种类及伤情,采用不同方法修复重建,趾骨缺损仅修复软组织;跖骨缺损及跖趾关节缺损(多合并皮肤软组织缺损)应做同期重建修复,采用带血管骨与皮瓣串、并联吻接移植受区替代缺损跖骨及足部皮肤。结果自1994～2000年,47例前足损伤患者采用上述方法修复重建取得满意疗效,患足基本恢复行走负重功能及较理想外观。结论针对前足损伤伤情及部位进行分型,有助于指导治疗、精确描述和深入研究。采用带血管骨与带血管皮瓣组合移植是修复重建前足复合组织缺损的较理想方法。

Objective To study and discuss the problems involved in as well as the significance a nd methods of restoration and reconstr uction of forefoot defects.Methods Various procedures were adopted ac-cording to the wound variety and severity.For just absense of mefatarsal bones,only soft tissue was restored.For defects of metatarsals or metatarso phalangeal joints(usually associated with soft tissue defects)homochronous reconstruction and restoration was conducted by using vascularized bon e incorporation with free flap transplan-tation.Results Total 47cases wih forefoot defects were recpaired by using procedures me ntioned above from1994to 2000.All of this group regain ed their walking and weight-bearing functions as well as a good appearance.Conclusions Classification of forefoot injurie s according to their severity and loc ation is helpful in treatment,precise description and further stu dy of the injuries.Vascular bone incorporating with vascular flaps proved to be an ideal method of repairing compound defects.