胫骨创伤性骨髓炎伴软组织缺损的皮瓣修复分析

Analysis of flap for repairing tibia traumatic osteomyelitis complicated with soft tissue defect

目的探讨胫骨创伤性骨髓炎伴软组织缺损的皮瓣修复方法. 方法：选取我院2012-02/2013-02 收治的60 例胫骨创伤性骨髓炎伴软组织缺损患者,分析全部病例的临床治疗资料. 结果：本组60 例患者均获随访资料,随访时间为6～12 个月,全部腓肠肌转移皮瓣Ⅰ期存活. Ⅰ期植骨7 例,Ⅱ期植骨15 例,其中3 例Ⅱ期植骨患者复发慢性骨髓炎,植骨失败,2 次清创后感染治愈;其余患者未复发感染,植骨效果良好,植骨愈合时间为3.5～6.8个月,平均愈合时间（4.7±0.6）个月.结论：在治疗胫骨创伤性骨髓炎伴软组织缺损中,胫骨腓肠肌皮瓣修复具有血供丰富、操作简单、成活率高及对重要血管干扰较小等优势,有利于改善病灶局部血液循环,促进创面恢复,提高临床治疗效果,缩短住院时间,减轻患者经济压力,提高患者生活质量,值得临床推广应用.

AIM:To analyze and discuss the method of flap for repairing tibial traumatic osteomyelitis with soft tissue defect. METHODS: A total of 60 cases tibial traumatic osteomyelitis with soft tissue defect in our hospital from February 2012 to February 2013 were selected, and the clinical data of all cases were retrospectively analyzed. RESULTS: The 60 patients were followed up for 6-12 months, all of the gastrocnemius muscle transfer flap survived. Ⅰ?stage bone graft were perfprmed in 7 cases, and Ⅱ?stage bone graft in were performed 15 cases. Among them, 3 cases with Ⅱ?stage bone graft recurred chronic osteomyelitis, and the infection were cured after 2 times debridement. And others had no infection with good curative effect, the healing time was 3.5-6.8 months, and average healing time was (4.7±0.6) months. CONCLUSION: In the treatment of traumatic tibia osteomyelitis with soft tissue defect, the method of tibial gastrocnemius myocutaneous flap has many advantages, such as abundant blood supply, simple operation, highly survival rate and the important blood vessels with litlle interference, which is good for improving the blood circulation of fracture, promoting healing of wound, improving clinical curative effect, shortening hospitalization time, relieving patients ’ economic pressure and improving their quality of life. It is worthly of clinical application.