Effect observation of flap grafting combined with Ilizarov external fixation in treatment of Gustilo Ⅲ tibiofibular fracture
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摘要: 目的 观察皮瓣转移术联合Ilizarov外固定术治疗Gustilo Ⅲ型胫腓骨骨折的疗效。 方法 对45例Gustilo Ⅲ型胫腓骨骨折患者行急诊彻底清创,有限切开修复胫腓骨的完整性,使用Ilizarov外固定架有效固定骨折。根据皮肤软组织缺损程度、位置及大小设计皮瓣,行Ⅰ期或Ⅱ期闭合创面修复。 结果 45例患者中,伤口Ⅰ期愈合20例(44.45%), Ⅱ期愈合22例(48.89%); 3例未达到Ⅰ期、Ⅱ期愈合患者中, 1例皮瓣浅层感染, 1例小面积骨外露并骨坏死, 1例皮瓣全部坏死,均经对症处理后最终愈合。本组患者骨折愈合率为100.00%, 平均骨折临床愈合时间11个月。 结论 皮瓣转移术联合Ilizarov外固定术是修复Gustilo Ⅲ型胫腓骨骨折的有效、可行的方法。
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关键词:
- 皮瓣转移术 /
- Ilizarov外固定术 /
- Gustilo Ⅲ型胫腓骨骨折 /
- 疗效
Abstract: Objective To observe the effect of flap grafting combined with Ilizarov external fixation in treatment of Gustilo Ⅲ tibiofibular fracture. Methods Totally 45 patients with Gustilo Ⅲ tibiofibular fracture were treated with emergency debridement and limited incision to repair the integrity of tibia and fibula, and the effective fixation of fracture was achieved by Ilizarov external fixator. According to the degree, location and size of the skin and soft tissue defect, the skin flaps were designed for stage Ⅰ or Ⅱ closed wound repair. Results Among 45 patients, there were 20 cases(44.45%)with stage Ⅰ wound healing and 22 cases(48.89%)with stage Ⅱ wound healing. Among 3 cases without stage Ⅰ or Ⅱ healing, there were 1 case with superficial flap infection, 1 case with small area of bone exposure, and 1 case with all flaps necrosis, and the wounds were all healed after symptomatic treatment. The fracture healing rate of 45 cases was 100.00%, and the average clinical healing time was 11 months. Conclusion Flap grafting combined with Ilizarov external fixation is an effective and feasible method for repair of Gustilo Ⅲ tibiofibular fractures. -
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