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胫骨旋转截骨术后严重血管并发症通过游离功能性背阔肌肌瓣转移挽救：1例病例报告。

Severe vascular complications after derotational osteotomy of the tibia salvaged with free functional latissimus dorsi muscle transfer. A case report.

作者信息

de Jong T, van Alfen N, van Heerwaarden R J, Walbeehm E T, Nijhuis T H J

机构信息

Radboud Peripheral Nerve Centre, Department of Plastic and Reconstructive Surgery, Radboud university medical center, Nijmegen, the Netherlands.

Department of Neurology and Clinical Neurophysiology, Donders Center for Neuroscience, Radboud university medical center, Nijmegen, the Netherlands.

出版信息

JPRAS Open. 2024 Sep 19;42:208-212. doi: 10.1016/j.jpra.2024.09.010. eCollection 2024 Dec.

DOI:10.1016/j.jpra.2024.09.010
PMID:39398274
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11470784/
Abstract

We present a case study of a 26-year-old male who sustained severe vascular and neurogenic injury during derotational osteotomy of the tibia. Directly postoperatively he complained of a drop foot, but 3 days later presented with an ischemic compartment syndrome of the anterior and lateral compartments. After debridement the osteotomy and metalware were exposed and the patient had a drop foot. Here we report how we salvaged his lower limb with a free functional latissimus dorsi muscle transfer that reconstructed soft tissues and restored ankle dorsiflexion.

摘要

我们报告一例26岁男性患者，其在胫骨旋转截骨术中遭受了严重的血管和神经损伤。术后即刻，他主诉足下垂，但3天后出现了前侧和外侧肌间隔的缺血性肌间隔综合征。清创术后，截骨部位和金属器械暴露在外，患者仍存在足下垂。在此，我们报告如何通过游离功能性背阔肌转移术挽救其下肢，该手术重建了软组织并恢复了踝关节背屈功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/7ecd4f1e0178/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/c4315ee83198/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/e2756e34860b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/7ecd4f1e0178/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/c4315ee83198/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/e2756e34860b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8eb/11470784/7ecd4f1e0178/gr3.jpg

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本文引用的文献

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Microsurgical Reconstruction for Reanimation of Foot Dorsiflexion in Children.小儿足背屈功能重建的显微外科手术
Plast Reconstr Surg Glob Open. 2022 Mar 29;10(3):e4041. doi: 10.1097/GOX.0000000000004041. eCollection 2022 Mar.
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A review of functional latissimus dorsi transfers for absent elbow flexion and supination.关于用于治疗肘部屈曲和旋后功能缺失的背阔肌功能性转移的综述。
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肩胛带肌骨肉瘤全切除后三角肌的功能重建。
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Quadriceps muscle reconstruction with free functioning latissimus dorsi muscle flap after oncological resection.肿瘤切除术后采用游离功能性背阔肌肌瓣进行股四头肌重建。
Microsurgery. 2009;29(3):189-98. doi: 10.1002/micr.20607.
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Free innervated latissimus dorsi muscle flap for reconstruction of full-thickness abdominal wall defects.游离神经支配背阔肌肌皮瓣修复全层腹壁缺损
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Clin Orthop Relat Res. 1992 Oct(283):285-9.