腓动脉复合组织瓣移植治疗跟骨慢性骨髓炎骨皮缺损疗效观察

Observation the Treatment of Chronic Osteomyelitis with Calcaneus Bone Defect by Peroneal Artery Combined Flap Transplantation Efficacy

目的:观察腓动脉复合组织瓣移植治疗跟骨慢性骨髓炎的疗效。方法:选取2009年1月—2013年12月间收治的21例跟骨慢性骨髓炎患者,骨髓炎病因:开放骨折11例,闭合骨折10例。病灶清除后,骨缺损范围1.0cm×1.5cm×1.0cm^2cm×2.5cm×4cm,皮肤缺损面积2cm×1cm^4cm×5cm。观察患者手术时间、伤口愈合情况、术后随访情况。结果:21例跟骨骨髓炎患者手术时间2~3h,平均手术时间(2.1±0.4)h。术后随访18个月~6.5年,平均随访35个月。18例患者植皮区创面均一期愈合,3例创面渗出,经过2~6周的换药后创面干燥,二期愈合。随访期内无1例复发。结论:腓动脉复合组织瓣移植可填塞跟骨骨髓炎术后空腔、修复软组织缺损、增加局部血运,控制感染,是治疗跟骨骨髓炎的有效方法之一。

Obective: To observe the effect of composite tissue flap of peroneal artery in the treatment of chronic osteomyelitis of calcaneus for 21 cases. Methods: From January 2009 to December 2013,21 patients with chronic osteomyelitis of the calcaneus were treated. Osteomyelitis causes: 11 cases of open fractures,10 cases of closed fractures. After debridement,the bone defect ranges from 1. 0 cm × 1. 5 cm × 1. 0 cm to 2 cm × 2. 5 cm × 4 cm,and the skin defect area ranges from 2 cm × 1 cm to 4 cm ×5 cm. Results: The mean operative time in 21 patients with calcaneal osteomyelitis was 2 ~ 3 hours and the mean time was( 2.1 ± 0. 4) h. The follow-up period was 18 months to 6. 5 years with an average of 35 months. Wound healing was achieved in all of the 18 patients. The wounds were worn out in 3 patients and the wounds healed after 2 ~ 6 weeks. No recurrence was found during follow-up. Conclusion: Fibular artery composite tissue flap transplantation can fill the postoperative calcaneal osteomyelitis cavity,repair soft tissue defects,increase local blood supply,and control of infection,which is the treatment of calcaneal osteomyelitis is one of the effective methods.