CAJ | 학술논문

目的探讨游离腓骨复合组织瓣移植修复前臂骨与软组织重度缺损的效果. 方法自2004年3月至2011年2月,采用游离腓骨复合组织瓣移植治疗前臂骨与软组织重度缺损11例,移植复合组织瓣腓骨长度8 ～ 14 cm,皮瓣面积5cm×8cm～20cm×20cm.术后3、6、12个月观察骨折愈合情况,1年后评定伤肢功能. 结果 11例腓骨复合组织瓣全部成活,术后随访12个月以上,3个月即可见骨折端已有愈合征象,半年即可见腓骨与前臂骨折愈合良好,术后1年按Enneking系统评分平均22.9分；前臂旋转功能:优3例,良6例,差2例；2例腓肠神经桥接移植中,1例修复桡神经虎口静态两点辨别觉(s2PD)9 mm,1例修复尺神经小指末节掌侧s2PD 15 mm,所有病例拇指握拳、拇指与其他4指对指均可,供区踝关节活动正常. 结论游离腓骨复合组织瓣是修复前臂骨与软组织重度缺损的一种理想的手术方法.
목적 탐토유리비골복합조직판이식수복전비골여연조직중도결손적효과. 방법 자2004년3월지2011년2월,채용유리비골복합조직판이식치료전비골여연조직중도결손11례,이식복합조직판비골장도8 ～ 14 cm,피판면적5cm×8cm～20cm×20cm.술후3、6、12개월관찰골절유합정황,1년후평정상지공능. 결과 11례비골복합조직판전부성활,술후수방12개월이상,3개월즉가견골절단이유유합정상,반년즉가견비골여전비골절유합량호,술후1년안Enneking계통평분평균22.9분；전비선전공능:우3례,량6례,차2례；2례비장신경교접이식중,1례수복뇨신경호구정태량점변별각(s2PD)9 mm,1례수복척신경소지말절장측s2PD 15 mm,소유병례무지악권、무지여기타4지대지균가,공구과관절활동정상. 결론 유리비골복합조직판시수복전비골여연조직중도결손적일충이상적수술방법.
Objective To investigate the effect of free transplantation of fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect.Methods Eleven cases of reparing forearm bone and soft tissue serious defect through transplantation of free fibula composite tissue petal were applied from March 2004 to February 2011.The length of transplanted fibula composite tissue flap was 8-14 cm ; the flap area was 5 cm ×8 cm-20 cm ×20 cm.The curing situation on bone fracture was observed in 3,6 and 12 months after the surgical opration and the function of defected arm was evaluated in 1 year after surgical operation.Results All of 11 cases of fibula composite tissue flap were survived.The observation was undertaken for more than 12 months after the operation and the fracture section occured the characteristics of healing up in 3 months and fibula and arm bone occured well healed up in half a year; It scored 22.9 according to Enneking system after 1 year of the operation.The function of forearm rotation were classed as this:3 good cases,6 medium cases and 2 poor cases.In the 2 sural nerve bridging transplantation cases,one case was repaired of radial nerve inside static's two-point discrimination (s2PD) to 9 mm,another case was repaired of ulnar nerve distal volar little finger s2PD to 15 mm.All the cases could achieve making a fist with thumb and a thumb could be oppoiste to other 4 fingers,and the ankle joint movement was normal.Conclusion Transplantion of free fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect is an ideal surgical operation method.