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带血管蒂髂嵴用于修复下肢骨与软组织缺损

[Vascularized pedicle iliac crest for the repair of bone and soft tissue defect of lower extremity].

作者信息

Wu Ke-jian, Hou Shu-xun, Zhang Wei-jia, Wang Fu, Guo Ji-dong, Sun Da-ming, Zheng Xiao-yong

机构信息

Department of Orthopedics, The 304th Hospital of People's Liberation Army, Beijing 100037, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2005 Jun 15;43(12):784-7.

Abstract

OBJECTIVE

To study the role of transplantation of the vascularized pedicle iliac crest for the repair of bone and soft tissue defect of lower extremity.

METHODS

The vascularized pedicle iliac crest was designed for the repair of bone and soft tissue defect of lower extremity according to anatomic feature of leg and foot. Skin graft was used for coverage of the iliac flap.

RESULTS

Skin survival could demonstrate the survival of the vascularized pedicle iliac crest indirectly one week postoperatively. Skin survived completely in 4 cases and partly in 3 cases. Callus was seen at the transplantation site one month postoperatively, and K-wires were removed 4 months later in the cases of metatarsal defect. The external fixators were removed in the cases of tibia defect 6 to 8 months postoperatively. The functions of lower extremities were restored in 2 to 4 months. The bone and soft tissue defects were repaired, and ultimate function and cosmetic effects were satisfied after the mean follow up of 10 months (ranged from 6 to 15 months).

CONCLUSION

Transplantation of the vascularized pedicle iliac crest is an ideal method for the repair of bone and soft tissue defect of lower extremity. The operation can be performed in one stage. The functions and cosmetic effects are better than the traditional methods.

摘要

目的

探讨带血管蒂髂嵴移植修复下肢骨与软组织缺损的作用。

方法

根据小腿及足部的解剖特点,设计带血管蒂髂嵴修复下肢骨与软组织缺损。采用植皮覆盖髂骨瓣。

结果

术后1周皮片存活可间接证明带血管蒂髂嵴存活。4例皮片完全存活,3例部分存活。术后1个月移植部位见骨痂形成,跖骨缺损者4个月后拔除克氏针。胫骨缺损者术后6至8个月拆除外固定架。下肢功能在2至4个月恢复。平均随访10个月(6至15个月)后,骨与软组织缺损得以修复,最终功能及美容效果满意。

结论

带血管蒂髂嵴移植是修复下肢骨与软组织缺损的理想方法。该手术可一期完成。其功能及美容效果优于传统方法。

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