Germann G, Steinau H U
Department of Plastic and Hand Surgery, Burn Center, BG Trauma Center, Ludwigshafen, Germany.
Plast Reconstr Surg. 1995 Oct;96(5):1130-5. doi: 10.1097/00006534-199510000-00021.
The concept of early "functional" soft-tissue coverage is demonstrated in three cases of severe skeletonizing avulsion/contusion injuries of the upper extremity, including the replantation of a "frozen" arm. According to the MESS score, all extremities would have been allocated to the amputation group. Therapeutic strategy consisted of primary repair of all neurovascular structures, serial debridements, and early definitive coverage with simultaneous restoration of the elbow flexor or extensor muscles. Flap survival was 100 percent in all patients, and the muscle strength achieved after vigorous physical therapy was rated M3 to M5. One patient was even able to return to competitive tennis.
早期“功能性”软组织覆盖的概念在三例上肢严重骨骼化撕脱/挫伤病例中得到了体现，其中包括一例“冷冻”手臂的再植。根据MESS评分，所有肢体都应被归入截肢组。治疗策略包括对所有神经血管结构进行一期修复、多次清创，以及早期确定性覆盖并同时修复肘部屈肌或伸肌。所有患者皮瓣存活率均为100%，经过积极物理治疗后达到的肌肉力量评级为M3至M5。一名患者甚至能够重返网球竞技赛场。
