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带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损
Hits: 2444   Download times: 1735   Received:November 20, 2015    
作者Author单位UnitE-Mail
张功林 ZHANG Gong-lin 兰州市兰州军区总医院全军骨科研究所, 甘肃 兰州 730050 Institute of Army Orthopaedics, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, Gansu, China 668zgl@163.com 
甄平 ZHEN Ping 兰州市兰州军区总医院全军骨科研究所, 甘肃 兰州 730050 Institute of Army Orthopaedics, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, Gansu, China  
陈克明 CHEN Ke-ming 兰州市兰州军区总医院全军骨科研究所, 甘肃 兰州 730050 Institute of Army Orthopaedics, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, Gansu, China  
李福民 LI Fu-min 民乐县中医院骨科, 甘肃 张掖 734500  
黄尧 HUANG Yao 民乐县中医院骨科, 甘肃 张掖 734500  
赵来绪 ZHAO Lai-xu 武山县人民医院骨科, 甘肃 天水 741300  
杨军林 YANG Jun-lin 武山县人民医院骨科, 甘肃 天水 741300  
周建华 ZHOU Jian-hua 武山县人民医院骨科, 甘肃 天水 741300  
薛钦义 XUE Qin-yi 武山县人民医院骨科, 甘肃 天水 741300  
期刊信息:《中国骨伤》2016年29卷,第4期,第365-368页
DOI:10.3969/j.issn.1003-0034.2016.04.016


目的:探讨带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损临床应用结果.

方法:2006年1月至2012年1月,应用带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损12例,男8例,女4例;年龄22~46岁,平均(38.1±1.6)岁.软组织缺损范围5 cm×11 cm~9 cm×16 cm.损伤后至手术时间6 h~21 d,平均(12.0±1.4) d. 间隔皮穿支和肌皮穿支皮瓣分别是4例和8例.在皮瓣上部皮下组织层向髂前上棘分离出股外侧皮神经,形成带感觉神经的股前外侧带蒂皮瓣.

结果:1例皮瓣发生小的皮缘裂开,术后1个月自然愈合,皮瓣全部成活.术后随访2.5~4.0年,平均(3.2±1.3)年.受区外形较好,皮瓣两点分辨觉7~13 mm,平均(9.1±1.2) mm.下肢功能用临床下肢评分(LEM)标准评定其疗效,优9例,良3例.

结论:这种技术安全、可靠,很适用于修复大粗隆部软组织缺损.
[关键词]:软组织损伤  外科皮瓣  股骨  外科手术
 
Repair of the soft tissue defect in the greater trochanter of femoral with innervated anterolateral thigh pedicled skin flap
Abstract:

Objective:To investigate the clinical application results of repairing the soft-tissue defect in the greater trochanter with innervated anterolateral thigh pedicled flap with sensory nerve.

Methods:From January 2006 to January 2012,12 patients(8 males,4 females) with soft-tissue defect in the greater trochanter underwent reconstruction with a innervated anterolateral thigh pedicled flap with sensory serve,ranging in age from 22 to 46 years old,(38.1±1.6) on average. Area of soft-tissue defect varied from from 5 cm×11 cm to 9 cm×16 cm. The operative time after injury were from 6 hours to 21 days,(12.0±1.4) on average. The septocutaneous and musculocutaneous perforator flaps were 4 and 8 cases respectively. At the upper portion of the flap,the lateral cutaneous femoral nerve was identified in subcutaneous tissue level toward the anterior superior iliac spine for innervated anterolateral thigh pedicled flap.

Results:One patient was developed small wound dehiscence,which spontaneous healed at 1 month after surgery. All the flaps were survived completely. Follow-up period after operation ranged from 2.5 to 4.0 years,(3.2±1.3) on average. A good contour was confirmed on the recipient area. Two-point discrimination sensation was 7 to 13 mm with an average of (9.1±1.2). The function of the lower extremity were evaluated with LEM,the excellent results were obtained in 9 cases,good results in 3 cases.

Conclusion:Satisfactory clinical results were obtained in this series. This technique is safe,reliable,and particularly useful for repairing the greater trochanter soft-tissue defect.
KEYWORDS:Soft tissue injuries  Surgical flaps  Femur  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:张功林,甄平,陈克明,李福民,黄尧,赵来绪,杨军林,周建华,薛钦义.带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损[J].中国骨伤,2016,29(4):365~368
英文格式:ZHANG Gong-lin,ZHEN Ping,CHEN Ke-ming,LI Fu-min,HUANG Yao,ZHAO Lai-xu,YANG Jun-lin,ZHOU Jian-hua,XUE Qin-yi.Repair of the soft tissue defect in the greater trochanter of femoral with innervated anterolateral thigh pedicled skin flap[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):365~368
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