CAJ | 학술논문

目的探讨带双皮岛的串式腓骨瓣游离移植修复前臂尺、桡骨及皮肤联合缺损的临床效果.方法自2005年6月至2009年7月,应用带双皮岛的串式腓骨瓣游离移植修复前臂尺、桡骨及皮肤联合缺损5例,修复尺骨的腓骨段长度4.5～7.5 cm,修复桡骨的腓骨段长度5.5～7.0 cm,皮瓣大小:5.0 cm×3.0 cm～8.0 cm×5.5 cm.术后12个月按Enneking评分系统测定患肢功能.结果 5例所应用的10块皮瓣全部成活,移植的腓骨段与尺、桡骨完全骨性愈合时间为4～6个月.术后随访时间14个月～2年,前臂旋转功能优2例、良2例、差1例,优良率为80%,按Enneking系统评分,平均为24.8分,平均恢复了肢体功能的81.3%.结论带血供的骨移植,骨细胞保持活性,利于骨质愈合,同时,该术式可以一次手术完成前臂多部位、多组织缺损的修复,因此,应用带双皮岛的串式腓骨瓣游离移植修复前臂尺、桡骨及皮肤联合缺损,是一种比较理想的治疗方法.
목적 탐토대쌍피도적천식비골판유리이식수복전비척、뇨골급피부연합결손적림상효과.방법자2005년6월지2009년7월,응용대쌍피도적천식비골판유리이식수복전비척、뇨골급피부연합결손5례,수복척골적비골단장도4.5～7.5 cm,수복뇨골적비골단장도5.5～7.0 cm,피판대소:5.0 cm×3.0 cm～8.0 cm×5.5 cm.술후12개월안Enneking평분계통측정환지공능.결과 5례소응용적10괴피판전부성활,이식적비골단여척、뇨골완전골성유합시간위4～6개월.술후수방시간14개월～2년,전비선전공능우2례、량2례、차1례,우량솔위80%,안Enneking계통평분,평균위24.8분,평균회복료지체공능적81.3%.결론 대혈공적골이식,골세포보지활성,리우골질유합,동시,해술식가이일차수술완성전비다부위、다조직결손적수복,인차,응용대쌍피도적천식비골판유리이식수복전비척、뇨골급피부연합결손,시일충비교이상적치료방법.
Objective To investigate the outcome of the free double-skin paddle string-type composite fibular flap in the reconstruction of the combined defects of ulna and radium. Methods From June 2005 to July 2009, 5 cases with combined defects of ulna and radium were reconstructed using the free double-skin paddle string-type composite fibular flap. The length of fibular segment for the reconstruction of ulnar defect ranges from 4.5 to 7.5 cm. The length of fibular segment for the reconstruction of radial defect ranges from 5.5 to 7.0 cm. The size of the flap varies from 5.0 cm × 3.0 cm to 8.0 cm × 5.5 cm. At the 12 month follow-up, the function of reconstructed forearm was evaluated based upon Enneking scoring system.Results Ten flaps in the 5 cases all survived. The time for the transplanted fibula healed on the radium and ulna was 4-6 months. The 5 patients were followed up from 14 months to 2 years. The forearm rotation functions were excellent in 2 cases, good in 2 cases and poor in 1 case. The eligible rate was 80%. The average Enneking score was 24.8, which indicated an average of 81.3% recovery of limb function. Conclusion Bone graft with blood supply can ensure the activity of osteocytes, which facilitates the fracture union.Whilst, the procedure can reconstruct multi-location and multi-tissue defects in the forearm. Therefore, the double-skin paddle string-type composite fibular flap is an ideal alternative for the reconstruction of the combined defects of ulna and radium and the skin.