CAJ | 학술논문

目的探讨GustiloⅢC型浮膝损伤的显微外科修复及其临床疗效.方法对GustiloⅢC型浮膝损伤的患者10例10肢,按Fraser等分类:Ⅱa型3例,Ⅱb型2例,Ⅱc型5例.全部采用显微外科技术修复结合外固定架和损伤肢体部位筋膜间室广泛切开减压进行治疗.结果 10例8肢存活,2肢二期截肢.全部病例随访6个月至3年,8例达到骨性愈合,其中骨延迟愈合1例,骨不愈合2例,经手术植骨均治愈,1例因创伤性关节炎行膝关节融合术.组织瓣全部成活,质地与色泽较好；5例外形和功能良好,1例有窦道形成,经换药后愈合.结论 GustiloⅢC型浮膝损伤危及肢体的存活与功能,对伤肢主干血管重建、神经损伤及软组织缺损的修复是关键.应用显微外科技术修复与重建,可提高临床疗效.
목적 탐토GustiloⅢC형부슬손상적현미외과수복급기림상료효.방법 대GustiloⅢC형부슬손상적환자10례10지,안Fraser등분류:Ⅱa형3례,Ⅱb형2례,Ⅱc형5례.전부채용현미외과기술수복결합외고정가화손상지체부위근막간실엄범절개감압진행치료.결과 10례8지존활,2지이기절지.전부병례수방6개월지3년,8례체도골성유합,기중골연지유합1례,골불유합2례,경수술식골균치유,1례인창상성관절염행슬관절융합술.조직판전부성활,질지여색택교호；5예외형화공능량호,1례유두도형성,경환약후유합.결론 GustiloⅢC형부슬손상위급지체적존활여공능,대상지주간혈관중건、신경손상급연조직결손적수복시관건.응용현미외과기술수복여중건,가제고림상료효.
Objective To observe the clinical effect of microsurgical repair of Gustilo Ⅲ C floating knee injuries.Methods Ten patients with Gustilo Ⅲ C floating knee injuries were treated by operation.10 wounded limbs were classified according to Fraser classification:Ⅱ a in 3 cases,Ⅱb 2 cases,Ⅱ c 5 cases.All cases were taken the treatment of microsurgical repair combined with external fixation and fascia compartment extensive decompression.Results 8cases survived,and Phase Ⅱ amputation were procedured in 2 cases.All the patients were followed up for 6 to 36 months.There were 8 cases osseous healing,including 1 case delay union and 2 cases non-union cured by bone graft,1 case was treated with knee arthrodesis for traumatic arthritis.Tissue flap all survived with good texture,colour and lustre.5 cases had fine appearance and function.1 case had fistula form and was cured after changing medicine.Conclusion Gustilo Ⅲ C floating knee injuries can endanger the survival and function of the limbs,and the healing keys were backbone vascular reconstruction of injury limb and repair of nerve damage and soft tissue defect.Using microsurgical technique to repair and rebuild can improve the clinical efficacy.