中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (53): 9101-9106.doi: 10.3969/j.issn.2095-4344.2013.53.001

• 细胞与组织移植 cell and tissue transplantation •    下一篇

逆行腓肠神经营养血管肌皮瓣移植治疗慢性跟骨骨髓炎

蔡幸健,周建国,钱  锐,肖诗梁   

  1. 赣州市人民医院骨科,江西省赣州市  341000
  • 修回日期:2013-11-19 出版日期:2013-12-31 发布日期:2013-12-31
  • 通讯作者: 钱锐,副主任医师,赣州市人民医院骨科,江西省赣州市 341000 qianrui1027@163.com
  • 作者简介:蔡幸健,男,1973年生,汉族,江西省南康市人,1999年江西医学院(现南昌大学医学院)毕业,副主任医师,主要从事关节外科、小儿骨科的临床与基础研究。 2517442496@qq.com 并列第一作者:周建国,主治医生,主要从事关节外科、脊柱外科、创伤骨科及骨肿瘤的基础临床研究。 157029069@qq.com
  • 基金资助:

    江西省卫生厅课题项目(20123205)*

Retrograde sural neurovascular flap transplantation for chronic calcaneal osteomyelitis

Cai Xing-jian, Zhou Jian-guo, Qian Rui, Xiao Shi-liang   

  1. Department of Orthopedics, People’s Hospital of Ganzhou, Ganzhou  341000, Jiangxi Province, China
  • Revised:2013-11-19 Online:2013-12-31 Published:2013-12-31
  • Contact: Qian Rui, Associate chief physician, Department of Orthopedics, People’s Hospital of Ganzhou, Ganzhou 341000, Jiangxi Province, China qianrui1027@163.com
  • About author:Cai Xing-jian, Associate chief physician, Department of Orthopedics, People’s Hospital of Ganzhou, Ganzhou 341000, Jiangxi Province, China 2517442496@qq.com Zhou Jian-guo, Attending physician, Department of Orthopedics, People’s Hospital of Ganzhou, Ganzhou 341000, Jiangxi Province, China 157029069@qq.com Cai Xing-Jian and Zhou Jian-guo contributed equally to this work.
  • Supported by:

     the grant from Jiangxi Health Bureau, No. 20123205*

摘要:

背景:跟骨骨髓炎治疗既要彻底消除骨髓炎感染灶,封闭创面,修复缺损软组织,又要恢复肢体正常形态,最大可能保护足的负重功能。由于腓肠神经营养血管肌皮瓣不损伤下肢的主要血管,且其旋转弧度大,血供恒定可靠,适于修复慢性跟骨骨髓炎创面。

目的:观察逆行腓肠神经营养血管肌皮瓣治疗慢性跟骨骨髓炎的效果。
方法:赣州市人民医院骨科2008年5月至2012年6月收治28例慢性跟骨骨髓炎患者,彻底清创后采用逆行腓肠神经营养血管肌皮瓣移位移植治疗,供区直接缝合23例,植皮覆盖5例。

结果与结论:28例患者移植后逆行移位肌皮瓣全部成活,其中4例出现肌皮瓣远端皮缘部分坏死,均经换药后愈合;所有患者肌皮瓣无臃肿,质地优,外形满意,功能感觉良好,跟骨骨髓炎未见复发,无并发症发生,所有患者均恢复正常行走。提示逆行腓肠神经营养血管肌皮瓣是治疗慢性跟骨骨髓炎的一种有效可行的方法。



中国组织工程研究
杂志出版内容重点:肾移植肝移植移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植组织工程


全文链接:

关键词: 器官移植, 组织移植, 皮瓣, 跟骨, 慢性骨髓炎, 软组织缺损, 损伤, 移植, 省级基金

Abstract:

BACKGROUND: Calcaneal osteomyelitis treatment is necessary that not only eliminates foci of osteomyelitis, seals the wound, repairs soft tissue defects, but also restores normal body shape and protects weight-bearing foot function as much as possible. Sural neurovascular flaps cannot damage major blood vessels of the lower limbs and appears to have the large arc of rotation, constant and reliable blood supply, which are suitable for repair of chronic calcaneal osteomyelitis.
OBJECTIVE: To study the operating method and clinical results of repairing chronic calcaneal osteomyelitis using retrograde sural neurovascular island flaps.
METHODS: Totally 28 patients with chronic calcaneal osteomyeliti were treated with the distally-based sural musculocutaneous flap in the Department of Orthopedics, People’s Hospital of Ganzhou, from May 2008 to June 2012. The donor defects were closed primarily in 23 patients and were resurfaced with the split-thickness skin graft in five patients.
RESULTS AND CONCLUSION: All the musculocutaneous flaps survived completely in 28 cases, four of which got some distal necrosis of the skin flap, and cured by dressing. All the flaps had good shapes and well-function, and exhibited no recurrence of osteomyelitis. All patients were able to walk normally. These findings indicate that the retrograde sural neurovascular flap transplantation is effective and feasible for treatment of chronic calcaneal osteomyelitis.



中国组织工程研究
杂志出版内容重点:肾移植肝移植移植;心脏移植;组织移植;皮肤移植;皮瓣移植;血管移植;器官移植组织工程


全文链接:

Key words: osteomyelitis, calcaneus, surgical flaps, sural nerve

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