Du Yongjun, Yu Chen, Peng Zhi, Lv Yan, Ta Wufei, Lu Sheng
Medical School, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China.
Department of Orthopedics, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650034, P.R. China.
Exp Ther Med. 2022 Aug 2;24(4):610. doi: 10.3892/etm.2022.11546. eCollection 2022 Oct.
Gustilo-Anderson III Type C open fracture is a high-energy injury with severe bone defects and extensive soft-tissue and vascular damage. Successful limb salvage remains challenging for surgeons due to the inherent risks of vascular damage, infection, nonunion and even amputation. The present case study reports on a 55-year-old male who presented with a Gustilo-Anderson III type C open fracture, which was successfully salvaged by a combined Masquelet and microsurgical approach. The modified Sauve-Kapandji technique was used to improve wrist mobility. Sufficient preoperative evaluation, a detailed surgical plan, positive revascularization, thorough debridement and prevention of complications are key to successful limb salvage. The range of motion test was excellent one year after surgery. The patient was able to take care of their daily life, return to performing a light-labor job and is satisfied with the function of the limb. Therefore, the Masquelet technique combined with modified Sauve-Kapandji technique, negative pressure drainage and skin-flap transplantation may be a reasonable and effective treatment for Gustilo-Anderson III type C open forearm fracture.
Gustilo-AndersonⅢ型C型开放性骨折是一种高能量损伤，伴有严重的骨缺损以及广泛的软组织和血管损伤。由于存在血管损伤、感染、骨不连甚至截肢等固有风险，保肢手术对外科医生来说仍然具有挑战性。本病例研究报告了一名55岁男性，其患有Gustilo-AndersonⅢ型C型开放性骨折，通过Masquelet技术与显微外科技术相结合成功实现了保肢。采用改良的Sauve-Kapandji技术来改善腕关节活动度。充分的术前评估、详细的手术计划、积极的血管重建、彻底的清创以及并发症的预防是保肢成功的关键。术后一年的关节活动度测试结果良好。患者能够自理日常生活，重返轻度体力工作岗位，并且对肢体功能感到满意。因此，Masquelet技术联合改良的Sauve-Kapandji技术、负压引流及皮瓣移植可能是治疗Gustilo-AndersonⅢ型C型开放性前臂骨折的一种合理且有效的方法。
