Ilizarov技術(shù)聯(lián)合皮瓣即時(shí)擴(kuò)張技術(shù)Ⅰ期矯正合并皮膚攣縮的脛骨成角畸形
發(fā)布時(shí)間:2019-03-25 09:21
【摘要】:目的:探討采用Ilizarov技術(shù)聯(lián)合皮瓣即時(shí)擴(kuò)張技術(shù)Ⅰ期矯正合并皮膚攣縮的脛骨成角畸形的臨床療效及安全性。方法:自2010年1月至2015年1月,采用Ilizarov外固定技術(shù)聯(lián)合攣縮側(cè)皮膚術(shù)中即時(shí)擴(kuò)張技術(shù)Ⅰ期矯正合并皮膚攣縮的脛骨成角畸形患者30例,男21例,女9例;年齡25~60歲,平均(40.2±5.5)歲。定期復(fù)查X線片,去除Ilizarov外固定后采用美國特種外科醫(yī)院(HSS)評(píng)分標(biāo)準(zhǔn)評(píng)定膝關(guān)節(jié)功能,并采用疼痛視覺模擬評(píng)分(VAS)評(píng)價(jià)其疼痛緩解程度。結(jié)果:術(shù)后所有患者獲隨訪,時(shí)間6~35個(gè)月,平均22個(gè)月。其中29例患者切口均Ⅰ期愈合,1例患者出現(xiàn)切口感染并發(fā)骨髓炎,2例患者并發(fā)固定釘松動(dòng),擴(kuò)張皮瓣區(qū)均無壞死,無神經(jīng)血管牽拉損傷癥狀。術(shù)后4~7個(gè)月去除外固定架,平均(5.2±1.1)個(gè)月。矯正成角角度10°~35°,平均(25.5±3.5)°。術(shù)后根據(jù)HSS評(píng)分標(biāo)準(zhǔn),總分92.5±6.6,其中優(yōu)25例,良4例,中1例;VAS評(píng)分1.2±1.5。結(jié)論:采用Ilizarov技術(shù)聯(lián)合皮瓣即時(shí)擴(kuò)張技術(shù)能夠Ⅰ期矯正合并皮膚攣縮的脛骨成角畸形,帶架時(shí)間短,無皮膚壞死及神經(jīng)癥狀,能夠早期負(fù)重鍛煉并改善患肢功能。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Ilizarov technique combined with immediate expansion of skin flap in the treatment of tibial angular deformity with skin contracture. Methods: from January 2010 to January 2015, 30 patients (21 males and 9 females) with tibial angular deformity were treated with Ilizarov external fixation combined with immediate skin expansion during skin contracture. The mean age was (40.2 鹵5.50) years. The function of knee joint was evaluated by (HSS) scoring standard of American Special surgery Hospital and the pain relief degree was evaluated by (VAS) after regular reexamination of X-ray films and removal of Ilizarov external fixation. Results: all patients were followed up for 6 months and 35 months (mean 22 months). There were 29 cases of wound healing, 1 case of incision infection complicated with osteomyelitis, 2 cases of loosening of fixation nail, no necrosis of dilated flap area and no symptoms of neurovascular traction injury. The external fixator was removed 4 months after operation with an average of (5.2 鹵1.1) months. The angle of correction ranged from 10 擄to 35 擄, with an average of (25.5 鹵3.5) 擄. According to the HSS score, the total score was 92.5 鹵6.6, among which 25 cases were excellent, 4 cases were good, 1 case was middle, and the VAS score was 1.2 鹵1.5. Conclusion: the technique of Ilizarov combined with immediate expansion of skin flap can correct the angular deformity of tibia with skin contracture in stage 鈪,
本文編號(hào):2446844
[Abstract]:Objective: to investigate the clinical efficacy and safety of Ilizarov technique combined with immediate expansion of skin flap in the treatment of tibial angular deformity with skin contracture. Methods: from January 2010 to January 2015, 30 patients (21 males and 9 females) with tibial angular deformity were treated with Ilizarov external fixation combined with immediate skin expansion during skin contracture. The mean age was (40.2 鹵5.50) years. The function of knee joint was evaluated by (HSS) scoring standard of American Special surgery Hospital and the pain relief degree was evaluated by (VAS) after regular reexamination of X-ray films and removal of Ilizarov external fixation. Results: all patients were followed up for 6 months and 35 months (mean 22 months). There were 29 cases of wound healing, 1 case of incision infection complicated with osteomyelitis, 2 cases of loosening of fixation nail, no necrosis of dilated flap area and no symptoms of neurovascular traction injury. The external fixator was removed 4 months after operation with an average of (5.2 鹵1.1) months. The angle of correction ranged from 10 擄to 35 擄, with an average of (25.5 鹵3.5) 擄. According to the HSS score, the total score was 92.5 鹵6.6, among which 25 cases were excellent, 4 cases were good, 1 case was middle, and the VAS score was 1.2 鹵1.5. Conclusion: the technique of Ilizarov combined with immediate expansion of skin flap can correct the angular deformity of tibia with skin contracture in stage 鈪,
本文編號(hào):2446844
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