腓骨瓣口-手修稿后.docVIP

带血管蒂游离腓骨瓣移植修复尺骨骨缺损 耿树岩 张文强1 王成琪 马振杰1 窦宏磊1 唐胜建* [摘要] 目的 介绍应用带血管蒂游离腓骨瓣移植修复尺骨骨缺损。方法 切取带有腓血管供血的腓骨上3/4段修复尺骨骨缺损13例，对其中4例，采用腓骨骨皮瓣联合修复；骨瓣长度最大为16cm，最小为6cm；腓骨骨皮瓣的皮瓣面积最大为25cm×12cm，最小为15cm×8cm。结果 13例9块腓骨瓣4块腓骨骨皮瓣全部成活。术后11例获得4月~24个月的随访，骨折处对位对线良好，呈骨性愈合。前臂旋前旋后良好，功能基本恢复正常。结论 应用带血管蒂游离腓骨瓣修复尺骨骨缺损，方法可靠，既修复长骨骨缺损，保持长度，又为骨折愈合提供血管营养，是一种理想的手术方法。 [关键词] 游离腓骨瓣 尺骨骨缺损 修复 显微外科 The reconstruction of ulna bone defects repairing with free fibula flap Geng shuyan，Zhang wenqiang，Wang chengqi，Tang shengjian，et al. Institute of plastic surgery,Wei-fang Medical College , Wei-fang 261041 [Abstract] Objective To introduce the application of free fibula flap transfer for reconstruction the defect of ulna. Methods Free fibula flap was defined as the upper 3/4 of the asis of fibula nurtured by the peroneal artery. Since 1996,13 consecutive cases of the ulna defect were treated with these flaps. Four of these cases were treated with bone-skin complex. The length of the flaps ranged from 5cm to 16cm, and the area ranged from 15cm?cm to 25cm?12cm. Results All 13 flaps including 9 fibula flaps and 3 bone-skin complex survived completely. Sufficient follow-up was obtained in 11 patients, ranging from 4 months to 24 months. The reconstructed ulnas were found to have good apperance. The union of the fracture was so nice. The fracture healed so well in line and in position. The prone function of the reconstructed ulnas recovered mostly. Conclusion Free fibula flap transfer can be applied to repair the defects of long bone. The operation not only can keep the length of the ulnas but also can nurture the fracture from the peroneal artery. Due to its constant vascular anatomy and technical ease of harvestiny, this flap is a reliable and optional choice for the management of this type of injury. [Keywords] Free fibula flaps; The defect of ulna; Reconstruction; Microsurgery 自1975年Taylor[1]首次报道应用吻合血管的腓骨移植治疗2例外伤性胫骨大段骨质缺损以来，带血管腓骨瓣移植修复骨缺损，特别是四肢长管状骨缺损在临床上得到广泛的应