【摘要】 目的探讨下肢严重开放性损伤的显微外科修复及临床疗效。方法对下肢损伤根据Gustil和Andserson分类ⅢB 16例、ⅢC 29例,采用显微外科技术修复结合稳定的固定方法和损伤肢体部位筋膜间室广泛切开减压进行治疗。结果38例43肢存活,7例二期截肢。全部病例随访5~60个月,骨折愈合,无骨关节感染发生,组织瓣全部成活,质地与色泽较好;存活肢体外形与功能满意16例,基本满意20例,不满意2例。结论下肢严重开放性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。更多还原

【Abstract】 Objective To probe into the method and the therapeutic effect of the treatment of severe open injury to the lower limb by microsurgery.Methods Sixteen cases of type Ⅲ B and 29 cases of type Ⅲ C classified according to Gustilo and Andserson were treated by microsurgical repair fixation and reducing pressure in the limb.Result Forty-three limbs in 38 were survived,7 cases were amputated in the second periold.In the followed-up ranging from 5 to 60 months after the treatment,the fracture healed up well,the texture of the tissue flaps was fine,and no infection in osseous joint was reported.16 patients were satisfied with the appearance and the function of the limbs,20 patients consider the therapeutic effect was good and only 2 patients were dissatisfied.Conclusion The severe open injury to the lower limb jeopardizes the survival and the function of the limbs.The reconstruction of the blood vessels of the injured limbs,the repair to the nervous injury and the loss of soft tissue is the key to recover of the cases mentioned above.The clinical effect is improved by using the microsurgery in repair and the reconstruction.更多还原