| 腓肠肌肌瓣转移治疗髌骨内固定术后感染 |
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Received:June 22, 2018
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| 作者 | Author | 单位 | Unit | E-Mail |
| 林炳远 |
LIN Bing-yuan |
浙江省立同德医院骨科, 浙江 杭州 310012 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 郭峭峰 |
GUO Qiao-feng |
浙江省立同德医院骨科, 浙江 杭州 310012 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 刘亦杨 |
LIU Yi-yang |
浙江省立同德医院骨科, 浙江 杭州 310012 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 黄凯 |
HUANG Kai |
浙江省立同德医院骨科, 浙江 杭州 310012 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 张春 |
ZHANG Chun |
浙江省立同德医院骨科, 浙江 杭州 310012 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
hzbone@163.com |
| 沈立锋 |
SHEN Li-feng |
浙江省立同德医院骨科, 浙江 杭州 310012 |
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 期刊信息：《中国骨伤》2018年31卷，第10期，第899-902页 |
| DOI：10.3969/j.issn.1003-0034.2018.10.004 |
| 基金项目:国家自然科学基金项目（编号：81603644）；浙江省医药卫生一般研究项目（编号：2016KYA057） |
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目的：探讨应用腓肠肌肌瓣治疗髌骨内固定术后感染的临床疗效。
方法：自2011年1月至2017年1月收治髌骨内固定术后感染患者15例，其中男9例，女6例；年龄31~66（42.5±11.2）岁；病程2~8（4.3±1.5）个月。全部病例在病灶清除后应用腓肠肌肌瓣修复创面，肌瓣表面行游离植皮，供区直接缝合。术后观察肌瓣存活及切口愈合情况，术后9个月采用黄永新等的皮瓣疗效标准和膝关节学会评分系统（KSS）进行膝关节功能评定。
结果：所有肌瓣顺利成活，无坏死。切口Ⅰ期愈合13例，术后裂开2例，经换药治疗后愈合。15例获得随访，时间9~30（20.6±8.3）个月。术后感染无复发，肌瓣质地好，皮肤色泽与受区相似，外形良好。参考黄永新等的皮瓣疗效标准，优13例，良2例。术后9个月KSS膝关节功能评分，其中临床评分为83.3±7.8，功能评分为86.3±10.4。
结论：应用腓肠肌肌瓣转移治疗髌骨内固定术后感染，疗效稳定，复发率低，值得临床推广应用。 |
| [关键词]:腓肠肌 髌骨 骨折固定术后,内 感染 |
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| Transfer of gastrocnemius muscle flap for postoperative infection with patellar internal fixation |
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Abstract:
Objective:To investigate clinical effect of gastrocnemius muscle flap for repairing postoperative infection of patellar internal fixation.
Methods:From January 2011 to January 2017,15 patients with postoperative infection of patellar internal fixation were treated,including 9 males and 6 females ranged from 31 to 66 years old with an average age of (42.5±11.2) years old. The courses of disease ranged from 2 to 8 months with an average of (4.3±1.5) months. All wounds were repaired by gastrocnemius muscle flap after debridement. The coverage of muscle flap was performed by free skin graft and donor site was closed directly. Survival of muscle flap,healing of incision were observed. HUANG Yong-xin clinical criteria and KSS score criteria were used to evaluate knee joint function 9 after operation.
Results:All muscle flaps were survived without necrosis. Incision of 13 patients were healed at stage Ⅰ,and 2 patients had wound dehiscence after operation and healed after symptomatic treatment. All patients were followed up from 9 months to 30 months with an average of(20.6±8.3) months. No recurrence of infection was observed,and texture of muscle flap,skin color,appearance were good. According to HUANG Yong-xin clinical criteria,13 excellent and 2 moderate. The clinical score of KSS score was 83.3±7.8,and functional score of KSS score was 86.3±10.4.
Conclusion:Gastrocnemius muscle flap is an effective method in repairing postoperative infection of patellar internal fixation with stable curative effect and low recurrence rate,which is worthy popularizing. |
| KEYWORDS:Gastrocnemius musle Patella Fracture fixation,internal Infection |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 林炳远,郭峭峰,刘亦杨,黄凯,张春,沈立锋.腓肠肌肌瓣转移治疗髌骨内固定术后感染[J].中国骨伤,2018,31(10):899~902 |
| 英文格式: | LIN Bing-yuan,GUO Qiao-feng,LIU Yi-yang,HUANG Kai,ZHANG Chun,SHEN Li-feng.Transfer of gastrocnemius muscle flap for postoperative infection with patellar internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(10):899~902 |
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