Chen Hui, Chen Zhong, Wang Jie, Tian Peng, Shen Yu-Ming, Huang Lei, Hu Xiao-Hua
Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing, P.R. China.
Department of Orthopedic Surgery, Beijing Jishuitan Hospital, Beijing, P.R. China.
J Burn Care Res. 2019 Jan 1;40(1):128-132. doi: 10.1093/jbcr/irx013.
Severe electrical injury presents a formidable therapeutic challenge for surgeons because of the requirement for complex soft tissue and bony reconstruction to restore functionality of the injured area. The authors report on the limb salvage procedure for a patient with extensive soft tissue and femoral bone necrosis from a high-voltage electrical burn. The right thigh and knee were burned, resulting in large areas of muscle necrosis and a long segment of distal femur exposure and necrosis. Complete debridement of the area resulted in a 20 × 35 cm soft tissue defect and an 18-cm long distal femoral bone defect. The wound was repaired through latissimus dorsi muscle transplantation and bony reconstruction using the sequential Ilizarov osteogenesis method. The injured limb was retained, and the functional recovery of the patient's leg was satisfactory. This experience indicates that the combination of flap transplantation and the Ilizarov osteogenesis method are good options for the treatment of large soft tissue and huge segmental bony defects.
严重电损伤对外科医生而言是一项艰巨的治疗挑战，因为需要进行复杂的软组织和骨重建以恢复受伤区域的功能。作者报告了一例因高压电烧伤导致广泛软组织和股骨坏死患者的保肢手术。右侧大腿和膝关节被烧伤，导致大面积肌肉坏死以及股骨远端长节段暴露和坏死。该区域的彻底清创造成了一个20×35厘米的软组织缺损和一个18厘米长的股骨远端骨缺损。通过背阔肌移植和采用伊里扎洛夫骨生成法进行骨重建修复了伤口。保留了受伤肢体，患者腿部的功能恢复令人满意。这一经验表明，皮瓣移植与伊里扎洛夫骨生成法相结合是治疗大面积软组织和巨大节段性骨缺损的良好选择。
