CAJ | 학술논문

目的：探讨腓骨皮瓣移植加外固定器固定修复胫骨缺损伴小腿软组织缺损的方法和临床疗效。方法2010年6月—2013年6月，应用外固定器固定胫骨骨折及骨缺损，同时行腓骨皮瓣移植，治疗胫骨缺损伴小腿软组织缺损共25例。结果25例腓骨皮瓣全部成活，胫骨及软组织缺损一期修复。外固定器固定牢固，骨折愈合快，移植骨与骨折端于术后3～6个月达骨性愈合，术后12～24个月，平均17个月后，移植腓骨胫骨化，患肢功能恢复良好，无一例发生骨不连、骨坏死、关节僵硬等并发症，功能恢复良好。结论腓骨皮瓣移植结合外固定器固定，可为植骨愈合创造有利条件，且固定牢靠，受区创伤小，可早期进行功能锻炼，避免应力遮挡，促进骨折愈合，是目前治疗胫骨缺损伴小腿软组织缺损的有效方法。
목적：탐토비골피판이식가외고정기고정수복경골결손반소퇴연조직결손적방법화림상료효。방법2010년6월—2013년6월，응용외고정기고정경골골절급골결손，동시행비골피판이식，치료경골결손반소퇴연조직결손공25례。결과25례비골피판전부성활，경골급연조직결손일기수복。외고정기고정뢰고，골절유합쾌，이식골여골절단우술후3～6개월체골성유합，술후12～24개월，평균17개월후，이식비골경골화，환지공능회복량호，무일례발생골불련、골배사、관절강경등병발증，공능회복량호。결론비골피판이식결합외고정기고정，가위식골유합창조유리조건，차고정뢰고，수구창상소，가조기진행공능단련，피면응력차당，촉진골절유합，시목전치료경골결손반소퇴연조직결손적유효방법。
Objective To describe the method and the clinical effect of the transplantation of fibular skeletal flap and external fixation for the repair of the defect of tibia and soft tissue defect of the leg. Methods 25 cases of tibia fractures associated with bone and soft tissue defects of leg were treated with external fixation device and transplantation of the fibular skeletal flap from Jun 2010 to Jun 2013. Results All the fibular skeletal flaps survived completely after operation, the defects were repaired at one setting, the external fixation were steady and the fracture healed smoothly. The bone graft healed with the host bone in 3 to 6 months, and grafted fibular healed with tibia 12 to 24 months after operation (17 months on average). The recovery of function of the limb were satisfactory. There were no major complication in this series. Conclusion The fibular skeletal flap can be used to repair the bone and soft tissue defect in the tibia at one setting. The external fixation device provides a convenient condition for bone graft and prevents the stress protection effect.