CAJ | 학술논문

目的探讨应用膝上外侧复合组织瓣修复组织缺损的临床效果.方法以大腿外侧正中为轴心线,股骨外上髁以近4 cm处为皮支入皮点,髌骨外侧缘向近端延长线为皮瓣的前缘,股二头肌后缘为皮瓣后缘,下界为髌骨上缘水平线,据创面需求设计膝上外侧复合组织瓣,并分别应用其修复四肢软组织缺损18例,跟腱缺损11例,四肢骨不连接16例.结果 2002年3月至2013年9月,应用膝上外侧复合组织瓣修复组织缺损45例,皮瓣最大面积为17 cm ×9cm,最小为6 cm×3 cm,术后皮瓣全部成活,虽有2例术后12h内发生血管危象,但经手术探查重新吻合血管后存活.术后随访1～2.5年,组织修复外形良好,修复的跟腱功能恢复良好,骨缺损、骨不连均已骨性愈合,效果满意.供区愈合良好,采用HSS膝关节功能评估系统评估术后8个月的膝关节功能均为优良.结论采用膝上外侧复合组织瓣,可一期修复皮肤软组织、骨和跟腱缺损.
목적 탐토응용슬상외측복합조직판수복조직결손적림상효과.방법 이대퇴외측정중위축심선,고골외상과이근4 cm처위피지입피점,빈골외측연향근단연장선위피판적전연,고이두기후연위피판후연,하계위빈골상연수평선,거창면수구설계슬상외측복합조직판,병분별응용기수복사지연조직결손18례,근건결손11례,사지골불련접16례.결과 2002년3월지2013년9월,응용슬상외측복합조직판수복조직결손45례,피판최대면적위17 cm ×9cm,최소위6 cm×3 cm,술후피판전부성활,수유2례술후12h내발생혈관위상,단경수술탐사중신문합혈관후존활.술후수방1～2.5년,조직수복외형량호,수복적근건공능회복량호,골결손、골불련균이골성유합,효과만의.공구유합량호,채용HSS슬관절공능평고계통평고술후8개월적슬관절공능균위우량.결론 채용슬상외측복합조직판,가일기수복피부연조직、골화근건결손.
Objective To investigate the clinical effect of lateral superior genicular composite tissue flap for tissue defect.Methods The axis line of flap is the lateral thigh vertical midline.The cutaneous branch is inserted 4 cm near the femoral lateral epicondylus.The anterior border is the elongation line along patellar lateral border.The posterior margin is thehinder margin of femoral biceps.The lower border is the horizontal line along the upper line of patella.The composite flaps were used in 18 cases with soft tissue defects in extremities,11 cases with clacaneus tenden defects and 16 cases with bony nonunion.Results From Mar.2002 to Sept.2013,45 cases were treated with the composite tissue flaps.The flaps size ranged from 6 cm × 3 cm to 17cm × 9 cm.All the flaps survived completely.Blood supply crisis happened in 2 cases,which was released by reanastomosis.The patients were followed up for 1-2.5 years with satisfactory aesthetic and functional results.All the bone defect and nonunion were healed.Good healing was also achieved in donor sites.8 months after operation,knee joint function is evaluated as good by hospital special surgery knee score (HSS).Conclusion Lateral superior genicular compostie tissue flap can be used to reconstruct soft tissue defect,bone defect and tenden calcaneus defect in one stage.