外固定器修复交通伤四肢组织缺损的护理

目的 报道游离组织瓣移植联合应用外固定器固定骨、关节用于修复交通伤四肢组织缺损伤的临床应用及护理.方法 对36例包括骨皮瓣、肌皮瓣、皮瓣移植,同时采用A-O管状外固定器、单侧多功能外固定器及单侧踝关节外固定器行骨关节外固定修复的患者进行观察护理.结果 36例交通伤患者肢体骨关节缺损愈合良好,移植皮瓣全部成活,术后上肢10～16周、下肢6～8个月拆除外固定器,肢体功能恢复满意,无畸形及骨不连接.结论 应用组织瓣移植同时以外固定器固定骨关节对交通伤肢体组织的复合性缺损进行修复和重建,具有骨关节固定简单可靠,肢体及移植组织损伤小等优点.而临床过程中的血运观察及护理,并结合早期的功能训练亦必必可少.

Nursing on external fixator repairing defects of limbs caused by traffic accidents

Objective To report the clinical result of repairing complex tissue defect in limb caused by traffic accident using both tissue flap transplantation and external fixer. Methods The vascular tissue flap including bone flap and muscular flap to repair the complex tissue defection ( soft tissue, bones, joints) in forearm, hand, leg, ankle and foot were applied in 36 cases. At the same time in surgery, injured bones and joints were fixed by external fixator for stabilizing and accelerating cure. Results All 36 cases were applied successfully with transplanted tissue combined with external fixator. The external fixator were moved away about 10～16 weeks post - operation in upper extremity or 6～8 months post - operation in lower extremity and all the cases recovered satisfactorily. Conclusions It is a reliable method for repairing the complex tissue defection in the limb caused by traffic accident by external fixator with traumatology and microsurgery technique. And it is also characterized as a minor injury method on transplanted bones, enables early exercise for joints, convenient observation of flap circulation and easy nursing.