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采用游离胫腓骨-距跟骨肌瓣和游离背阔肌瓣避免膝上截肢术

Avoiding Above-the-Knee Amputation with a Free Tibiofibular-Talocalcaneal Fillet Flap and Free Latissimus Dorsi Flap.

作者信息

Garcia-Vilariño Elena, Perez-Garcia Alberto, Salmeron-Gonzalez Enrique, Sanchez-Garcia Alberto, Bas Jose Luis, Simon-Sanz Eduardo

机构信息

Department of Plastic Surgery, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

Department of Traumatology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.

出版信息

Indian J Plast Surg. 2020 Mar;53(1):135-139. doi: 10.1055/s-0040-1708226. Epub 2020 Apr 1.

DOI:10.1055/s-0040-1708226
PMID:32367929
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7192697/
Abstract

Despite the advances achieved in reconstructive surgery, amputation is still the only option after some severe traumas. Preservation of the knee joint is considered a significant functional advantage. We present the case of a 39-year-old man with a comminuted Gustilo type IIIC open tibia fracture with massive bone loss. To achieve a well-fashioned amputation stump and preserve the knee joint, a free osteocutaneous fillet flap was performed, including the distal tibia and fibula, talus, and calcaneus bones. As a result, a sensate and long amputation stump covered with thick skin from the sole of the foot provided a stable coverage with an excellent functional result and adjustment to prosthesis.

摘要

尽管重建手术取得了进展，但在一些严重创伤后截肢仍是唯一选择。保留膝关节被认为具有显著的功能优势。我们报告一例39岁男性，患有Gustilo IIIC型开放性胫骨粉碎性骨折，伴有大量骨质缺损。为了获得外形良好的截肢残端并保留膝关节，实施了游离骨皮肌瓣移植术，包括胫骨远端、腓骨、距骨和跟骨。结果，一个带有来自足底厚皮覆盖的有感觉的长截肢残端提供了稳定的覆盖，功能效果极佳且便于安装假肢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/c1d54f9a647e/10-1055-s-0040-1708226_00182_07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/656acb774cbc/10-1055-s-0040-1708226_00182_01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/11cb6d544785/10-1055-s-0040-1708226_00182_02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/9f54b9cc96ef/10-1055-s-0040-1708226_00182_03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/6f3e416020bb/10-1055-s-0040-1708226_00182_04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/3c4d66cde0b6/10-1055-s-0040-1708226_00182_05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/1ad997662178/10-1055-s-0040-1708226_00182_06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/c1d54f9a647e/10-1055-s-0040-1708226_00182_07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/656acb774cbc/10-1055-s-0040-1708226_00182_01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/11cb6d544785/10-1055-s-0040-1708226_00182_02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/9f54b9cc96ef/10-1055-s-0040-1708226_00182_03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/6f3e416020bb/10-1055-s-0040-1708226_00182_04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/3c4d66cde0b6/10-1055-s-0040-1708226_00182_05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/1ad997662178/10-1055-s-0040-1708226_00182_06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/463b/7192697/c1d54f9a647e/10-1055-s-0040-1708226_00182_07.jpg

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Free microvascular rotationplasty with nerve repair for rhabdomyosarcoma in a 18-month-old patient.18个月大患者横纹肌肉瘤的游离微血管旋转成形术联合神经修复术
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