Department of Lower Limb Trauma, Beijing Jishuitan Hospital, Guizhou Hospital, Baiyun District, Guiyang, Guizhou, China.
Medicine (Baltimore). 2023 Oct 13;102(41):e35468. doi: 10.1097/MD.0000000000035468.
We report a case of a serious traffic accident injury to the lower leg involving a large skin defect with the long bone exposed. In this situation, the usual intervention is flap transplantation after debridement and infection control by completely covering the wound. Flap transplantation has certain limitations; therefore, we chose the surgical strategy of cortical bone drilling-induced membrane technology (Masquelet technique).
A 28-year-old healthy man was injured in a car accident and presented to the local hospital with a large skin defect and exposed left lower leg long bone. After transfer to our hospital, the patient underwent repeated debridement and skin graft, a cortex borehole combined with bone cement cover, and ankle fusion. The patient achieved full recovery.
From our experience in treating this case, we conclude that large skin defects, periosteal stripping, and bone exposure due to physical injury can be successfully treated with cortical perforation and the Masquelet technique so as to avoid flap transplantation. Therefore, this method can be used for large segment bone exposure.
我们报告一例小腿严重交通事故伤，伴有大面积皮肤缺损和长骨外露。在这种情况下，通常的干预方法是清创和感染控制后，通过完全覆盖伤口进行皮瓣移植。皮瓣移植有一定的局限性；因此，我们选择了皮质骨钻孔诱导膜技术（Masquelet 技术）的手术策略。
一名 28 岁健康男性因车祸受伤，被转送至当地医院，其左小腿有大面积皮肤缺损和长骨外露。转至我院后，患者接受了多次清创和植皮、皮质骨钻孔联合骨水泥覆盖、踝关节融合术。患者完全康复。
从我们治疗该病例的经验来看，我们认为，由于物理损伤导致的大面积皮肤缺损、骨膜剥离和骨外露，可以通过皮质穿孔和 Masquelet 技术成功治疗，从而避免皮瓣移植。因此，该方法可用于大段骨外露。
