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題 名 | Anterior Tibial Myoperiosteal Flap for Post-traumatic Tibial Osteomyelitis=使用前脛肌骨膜皮瓣解救脛骨慢性骨髓炎 |
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作 者 | 黃介琦; 戴浩志; 洪學義; 陳明庭; | 書刊名 | 中華民國重建整形外科醫學會雜誌 |
卷 期 | 8:3 1999.09[民88.09] |
頁 次 | 頁197-203 |
分類號 | 416.261 |
關鍵詞 | 慢性骨髓炎; 脛骨骨折; Anterior tibial myoperiosteal flap; Salvage of open tibial fracture; |
語 文 | 英文(English) |
中文摘要 | 一位77歲男性,因車禍造成左大腿骨骨折併左側脛腓骨開放性粉碎骨所(Gustillo IIIB),九個月以來因慢性骨髓炎造成上三分之一脛骨骨折不癒與缺損,內側腓腸肌皮瓣已使用但不幸失敗,留下6 × 6 × 5 cm的軟組織缺損併脛骨暴露缺損。血管攝影顯示下肢三條血管通暢,但有中等程度的動脈硬化。所以我們設計帶前脛動脈的前脛肌骨膜皮瓣,用來填塞軟組織缺損併加強脛骨骨折的癒合。術後皮瓣完全存活。術後八個月的追蹤,骨骼X光片和骨骼掃描檢查均顯示骨折處重新癒合。所以前脛肌骨膜皮瓣同時具備了肌肉皮瓣和骨瓣的優點,可運用於解救脛骨開放性骨折所造成的骨髓炎,軟組織缺損與骨折不癒。 |
英文摘要 | A patients of a 77-year-old male with a history of left femoral fracture and open tibio-fibular comminuted fracture (Gustilo type IIIB) had chronic osteomyelitis and non-union of upper-third tibial bone for 9 months. Due to the poor local conditions, the medial gastrocnemius myocutaneous flap was performed previously in vain. The size of the soft-tissue defect was 6.0 × 6.0 × 5.0 cm and severe scarring around the defect was noted. The angiography of the left lower leg revealed patent picture of the three main arteries, with moderate arteriosclerotic charges. The anterior tibial myoperiosteal flap based on the anterior tibial artery was designed for the coverage of the defect. After the aggressive debridement and sequestrectomy, the flap was elevated and turned over to tamponade the soft-tissue defect and therefore to accelerate osteogenesis. Complete survival of the flap was achieved. The roentgenography and bone scan revealed satisfactory reunion of the tibial bone after eight months' follow-up. This flap has both the advantages of the muscle and the periosteal flap. This myoperiosteal flap may be applied in the salvage operation for simultaneously treating osteomyelitis, soft-tissue defect and bony non-union following open tibial fracture. |
本系統中英文摘要資訊取自各篇刊載內容。