Khan U, Pickford M
Department of Plastic Surgery, The Queen Victoria Hospital, East Grinstead, West Sussex, UK.
Br J Plast Surg. 2000 Dec;53(8):705-6. doi: 10.1054/bjps.2000.3425.
Severe limb injuries present a challenge to the attending surgeon and there has been an emergence of complex modes of treatment. The Ilizarov technique for distraction osteogenesis is accepted as a worthwhile option in selected cases of massive segmental bone loss. The blood supply of the bone during this process has been studied experimentally but the response of the soft tissue envelope to the process of compression followed by slow and progressive elongation is not entirely understood. We present a case of lower limb trauma where a combined approach to reconstruction was required with acute shortening followed by distraction osteogenesis for a major segmental tibial defect. Late soft tissue reconstruction for persistent ulceration over the tibia was then undertaken using a distally based fasciocutaneous flap.
严重的肢体损伤给主治外科医生带来了挑战，并且出现了复杂的治疗方式。在选定的大面积节段性骨缺损病例中，伊利扎罗夫牵张成骨技术被认为是一种值得采用的选择。在此过程中，已对骨骼的血液供应进行了实验研究，但软组织包膜对压缩后缓慢渐进性延长过程的反应尚未完全了解。我们报告一例下肢创伤病例，该病例需要采用联合重建方法，先进行急性缩短，然后对主要的胫骨节段性缺损进行牵张成骨。随后，使用远端带蒂筋膜皮瓣对胫骨上持续溃疡进行晚期软组织重建。
