ABSTRACT
Objective To describe the method and clinical result of super sural neuromusculocutaneous flap grafting plus catheter irrigation in the treatment for chronic lateral malleolus osteomyelitis. Methods From March 2000 to March 2008, 17 cases, male 14, femal 3, 21 to 75 years old (average 43-year-old),were underwent reversed saphenous musculocutaneous island flap after wide excision of lateralmalleolus lesion. The cause of lateral-malleolus lesions was trauma. The smallest flap was 5 cm× 6 cm and the largest was 7 cm × 11 cm. Catheter irrigation was used in all cases. Results Follow-up ranged from 12 to 96 months, average 49 months. After operation, the wounds were irrigated with sensitive antibiotics 1 to 2.5 months(average 49 days), and all flaps were survived. Except 2 cases, the other 15 were healed in 1 month.The 2 cases were not healed at first stage. According to the lab result,we changed the antibiotic, and in 2.5 months, we took off the catheter. Conclusion To deal with the chronic traumatic lateral-malleolus osteomyelitis, super sural neuromusculocutaneous flap grafting plus catheter irrigation is approprite and effective.
ABSTRACT
[Objective]To evaluate the two plates internal fixation treating the distal humeral comminuted and complicated fracture.[Method]Twenty-eight patient with comminuted distal humeral fracture were treated with the double-plate internal fixation from April 2004 to April 2007.According to AO/ASIF classification method,all fractures were C types.There were 9 C1 types,15 C2 types,4 C3 types.All cases were taken from the middle of posterior elbow incision.The patients were treated with the open reduction and double plate internal fixation.Fifteen cases were done through the triceps tongue-shaped flap,13 cases were olecranon osteotomy (including one case with olecranon fractures with ipsilateral).Surgical steps included:the articular surface reduction of intra-articular fractures,small temporary Kirschner wire fixation,making the complete fractures into simple comminuted fractures of humerl condylar fractures,then resetting metaphysis.Internal fixation method used the restruction plate according to the size of fracture.The restruction plate was fixed in the back of the distal humeral radial column.One-third of a good-shaped tubular plate was used to fix the inner edge of humeral ulnar column,two 90 ? of each other into the plane separately fixed on the inner lateral humeral column.[Result]All cases were followed up for an average of 17 months(ranged,8-33 months).Fracture healing time ranged 8-16 weeks.Myositis ossificans was found in 1 case,joint space narrowing was found in 4 cases.No non-union and ulnar nerve injury were found.The final good-to-excellent rate was 82.1%.[Conclusion]The distal humeral comminuted fracture has complicated structure.The internal fixation with two plates and screws,and early functional exercise could improve the elbow function.It has satisfactory curative effect in clinic.