Müller K H, Rehn J
Aktuelle Traumatol. 1982 Apr;12(2):53-61.
As an introduction statements from literature and own experience are used to show and evaluate the present possibilities for the coverage of skin and soft tissue defects. As a routine operation the stemmed cross-leg flap is further on indicated on the lower leg. For the immobilisation of the legs wer use the fixateur externe. This kind of fixation has got advantages compared to plaster casts: optimal position of the two lower legs to each other, a local and general handling of the nursing with only few problems and a subjective relief for the patient. Moreover, flaps and transplant base can be connected permanently and without tension during the operation by fine adjustment of the fixateur externe, while postoperative functional strains of the neighbouring joints are possible to a certain degree. The technique of assembling the fixateur externe, i.e. immobilisation of the legs by Schanz screws and the AO-tubular system is described in detail. The results of a collective of 21 patients with mostly infectious soft tissue defects after an osteomyelitis of the tibia were checked by control examinations. There were no disadvantages for the donor leg following the use of Schanz screws. According to the presented results the settling of cross-leg flaps has been improved by the fixateur-externe-technique. Together with other authors we can recommend this method.
作为引言,我们引用文献中的陈述和自身经验来展示和评估目前覆盖皮肤及软组织缺损的可能性。作为常规手术,小腿仍采用带蒂交腿皮瓣。为固定双腿,我们使用外固定架。与石膏固定相比,这种固定方式具有优势:双小腿彼此位置最佳,护理的局部和整体操作问题少,患者主观感觉轻松。此外,术中通过对外固定架进行微调,皮瓣和移植基可以无张力地永久连接,同时术后相邻关节会出现一定程度的功能劳损。本文详细描述了外固定架的组装技术,即通过斯氏针和AO管状系统固定双腿。通过对照检查,对21例主要因胫骨骨髓炎导致感染性软组织缺损患者的情况进行了检查。使用斯氏针后,供区腿并无不良影响。根据所示结果,外固定架技术改善了交腿皮瓣的安置情况。我们与其他作者一致推荐这种方法。