应用外固定架结合皮瓣转移治疗合并软组织缺损的胫腓骨骨折

【目的】总结外固定架结合皮瓣转移技术治疗合并软组织缺损的胫、腓骨骨折的经验。【方法】应用架固定胫骨骨折，根据小腿皮肤软组织损伤情况选用股前外侧皮瓣、腓肠肌皮瓣、腓肠神经营养血管逆行岛状皮瓣等多种不同皮瓣修复。【结果】临床应用52例，其中合并软组织缺损的胫、腓骨骨折急诊治疗14例、骨或钢板外露31例、骨不愈合7例。经1年以上随访全部骨折均愈合，无感染发生。3例皮瓣出现小面积组织坏死，经换药后治愈，其余皮瓣成活良好。【结论】应用外固定架结合皮瓣转移技术是治疗合并软组织缺损的胫、腓骨骨折的有效方法。

Analysis on the treatment of fracture of tibia and fibula with soft tissue defect by application of external fixator combined with flap technique

Objective] To analyze the treatment of fracture of tibia and fibula with soft tissue defect of leg by external fixator combined with flap technique. Methods] External fixators to fix fracture of tibia and different kinds of musculo- cutaneous flaps were selected to repair soft tissue defect of leg according to soft tissue injury of leg. Results] A total of 52 cases were analyzed, including fracture of tibia and fibula with soft tissue defect 14 cases, bone and steel plate exposure caused by necrosis of soft tissue 31 cases and nonunion of bone fracture with sear 7 cases. After followed up for a year all bone fractures were healed without infection. All flaps survived very well except three flaps had a necrosis over a small area. Conclusions] External fixator combined with flaps technique is an effective method for treating fracture of tibia and fibula with soft tissue defect of leg.