【摘要】 目的总结游离旋股外侧动脉降支皮瓣在小腿开放骨折软组织损伤Gustilo-AndersonⅢB型修复中的疗效。方法笔者自2008-01—2015-02结合游离旋股外侧动脉降支解剖特点设计皮瓣、修复开放骨折创面缺损20例,将皮瓣的长度变成宽度使皮瓣供区直接缝合。结果术后皮瓣供区一期愈合,无血管危象发生。20例均获得随访6~24个月,平均12个月。股四头肌肌力达到5级,膝关节屈曲达130°~140°、伸直达0°~5°。皮瓣全部成活,仅1例皮瓣边缘小面积发黑坏死,经换药创面愈合,恢复保护性感觉,皮瓣色泽、质地良好;受区皮瓣稍臃肿,供瓣区遗留线状瘢痕。结论旋股外侧动脉降支皮瓣可一次修复Gustilo-AndersonⅢB型开放骨折软组织损伤,皮瓣供区直接缝合,缩短治疗周期,减轻患者痛苦,是修复创面软组织损伤Gustilo-AndersonⅢB型的理想方法之一。更多还原

【Abstract】 Objective To investigate the clinical curative effect of free descending branch of lateral femoral circumflex artery flap for repair of Gustilo-Anderson ⅢB injury in leg open fractures. Methods The wound defect of 20 patients with open fractures in leg from January 2008 to February 2015 was repaired with free descending branch of lateral femoral circumflex artery flap. The length of the flap changed into width and directly was sutured in flap donor site. Results Postoperative flap donor area primarily healed, without vascular crisis. All 20 patients were followed up for 6-24 months, an average of 12 months. Quadriceps muscle strength reached level 5, knee flexion 130°-140°, straight up to 0°-5°. All flaps survived. Only 1case had small area necrosis on flap edge, healed after the treatment, protective feeling was recovered, the color and texture of flap were good. The flap of the recipient area was a little bit swollen, and the donor area had a linear scar. Conclusion The free descending branch of lateral femoral circumflex artery flap can repair Gustilo-Anderson ⅢB soft tissue defect in leg open fractures, flap in donor site can be directly sutured, the treatment time is reduced, patients’ pain is decreased. It is an ideal method to repair Gustilo-Anderson ⅢB injury in leg.更多还原