中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2011年
6期
348-350
,共3页
滕云升%智丰%刘重%张朝%吴勐%王龙虎%梁高锋%李涛%段超鹏
滕雲升%智豐%劉重%張朝%吳勐%王龍虎%樑高鋒%李濤%段超鵬
등운승%지봉%류중%장조%오맹%왕룡호%량고봉%리도%단초붕
移植%上肢%外科皮瓣%腓骨%骨缺损
移植%上肢%外科皮瓣%腓骨%骨缺損
이식%상지%외과피판%비골%골결손
Transplantation%Upper extremity%Surgical flaps%Fibula%Bone defect
目的 探讨游离腓骨(皮)瓣移植修复上肢长段骨缺损的临床应用及效果.方法 自2000年6月至2010年12月,应用游离腓骨骨瓣修复上肢长段骨缺损12例,其中携带皮瓣4例.男11例,女1例；年龄19～ 55岁,平均35岁.修复肱骨缺损2例,尺骨缺损6例,桡骨缺损4例.腓骨瓣切取范围1.5 cm× 2.0 cm～ 12.0 cm× 16.0 cm,腓骨移植长度6.0～ 20.0 cm.结果 12例均成功并获得随访,随访时间平均2年5个月.4例携带皮瓣全部存活；创面Ⅰ期愈合11例,Ⅱ期愈合1例,愈合时间12～18 d；腓骨移植骨愈合时间3～6个月,平均4个月.应用Enneking上肢功能标准评分为22～29分,平均27分；供区无功能障碍.结论 游离腓骨(皮)瓣移植修复上肢长段骨缺损可一期完成骨缺损修复,且可同时解决软组织缺损.虽难度大、风险高,但仍是一种很理想的治疗方法.
目的 探討遊離腓骨(皮)瓣移植脩複上肢長段骨缺損的臨床應用及效果.方法 自2000年6月至2010年12月,應用遊離腓骨骨瓣脩複上肢長段骨缺損12例,其中攜帶皮瓣4例.男11例,女1例；年齡19～ 55歲,平均35歲.脩複肱骨缺損2例,呎骨缺損6例,橈骨缺損4例.腓骨瓣切取範圍1.5 cm× 2.0 cm～ 12.0 cm× 16.0 cm,腓骨移植長度6.0～ 20.0 cm.結果 12例均成功併穫得隨訪,隨訪時間平均2年5箇月.4例攜帶皮瓣全部存活；創麵Ⅰ期愈閤11例,Ⅱ期愈閤1例,愈閤時間12～18 d；腓骨移植骨愈閤時間3～6箇月,平均4箇月.應用Enneking上肢功能標準評分為22～29分,平均27分；供區無功能障礙.結論 遊離腓骨(皮)瓣移植脩複上肢長段骨缺損可一期完成骨缺損脩複,且可同時解決軟組織缺損.雖難度大、風險高,但仍是一種很理想的治療方法.
목적 탐토유리비골(피)판이식수복상지장단골결손적림상응용급효과.방법 자2000년6월지2010년12월,응용유리비골골판수복상지장단골결손12례,기중휴대피판4례.남11례,녀1례；년령19～ 55세,평균35세.수복굉골결손2례,척골결손6례,뇨골결손4례.비골판절취범위1.5 cm× 2.0 cm～ 12.0 cm× 16.0 cm,비골이식장도6.0～ 20.0 cm.결과 12례균성공병획득수방,수방시간평균2년5개월.4례휴대피판전부존활；창면Ⅰ기유합11례,Ⅱ기유합1례,유합시간12～18 d；비골이식골유합시간3～6개월,평균4개월.응용Enneking상지공능표준평분위22～29분,평균27분；공구무공능장애.결론 유리비골(피)판이식수복상지장단골결손가일기완성골결손수복,차가동시해결연조직결손.수난도대、풍험고,단잉시일충흔이상적치료방법.
Objective To explore the clinical application and results of free fibular osteocutaneous flap transplantation for repair of long bone defect of the upper extremity.Methods From June 2000 to December 2010,free fibular bone flap was applied to repair long bone defect of the upper extremity in 12 cases,among which 4 cases had osteocutaneous flap.Of the 12 cases,there were 11 males and 1 female.Their ages ranged from 19 to 55 years old,with 35 years old on average.The fibular bone flap was used to repair humerus shaft bone defects in 2 cases,ulnar bone defects in 6 cases,and radius bone defects in 4 cases.The area of the cutaneous fibular flap ranged from 1.5 cm × 2.0 cm to 12.0 cm × 16.0 cm.The length of fibular bone flap ranged from 6.0 cm to 20.0 cm. Results All 12 cases were successfully follow-up.The mean follow-up duration was 2 years and 5 months.All 4 cutaneous flaps survived completely.Wounds healed in the primary attempt in 11 cases and in the secondary attempt in 1 case (healing time ranged from 12 to 18 days).Bone healing time ranged from 3 to 6 months (4 months on average) in fibula transplantation.The Enneking score system was applied to evaluate the upper extremity function.Of the 12 cases,the mean score was 27 (their scores ranged from 22 to 29).There was no functional impairment of the donor sites.Conclusion Despite the technical difficulty and risk,transplantation of the free fibular osteocutaneous flap is an optimal method to repair long bone defect of the upper extremity in that it can repair defects of the bone and soft tissue simultaneously.
