RESUMO
<p><b>OBJECTIVE</b>To explore a treatment approach for severely injured lower extremities.</p><p><b>METHODS</b>The data of 42 patients with severely traumatic lower extremities from 1989 to 1999 were retrospectively reviewed. According to MESS (mangled extremity severity score) the mean score of all the limbs was 6.24+/-1.45, 34 cases had MESS score < 7 and 8 cases had MESS score > or = 7. Treatment approaches included microvascular anastomosis technique, compound tissue flap transplantation technique and compound bone tissue flap transplantation.</p><p><b>RESULTS</b>Two patients died after operation and one patient had delayed amputation of a lower limb. The rest 39 patients were followed up for 4-13 years. All the lower extremities of the 39 patients survived and had equal length. The 39 cases were evaluated by Chen's criterion, showing that 37 had good result (29, Chen I and 8, Chen II), 1 sufficient (Chen III) and 1 poor (Chen IV).</p><p><b>CONCLUSIONS</b>Successful emergency treatment of severely injured lower extremities could be achieved by using microsurgery techniques and strict controlling of lower extremity salvagel indications.</p>
Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicina de Emergência , Métodos , Seguimentos , Fraturas Ósseas , Terapêutica , Traumatismos da Perna , Terapêutica , Traumatismo Múltiplo , Terapêutica , Músculo Esquelético , Procedimentos Ortopédicos , Métodos , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Estudos Retrospectivos , Análise de Sobrevida , Transplante de Tecidos , Métodos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To study the effect of vascularized fibular graft on large defects of long bones and the monitoring method for the vascular status of the grafted fibula.</p><p><b>METHODS</b>From March 1988 to February 1998, 30 patients with long bone defects over 6 cm in length received vascularized fibular graft including a monitoring island flap in our department to monitor the blood circulation of the fibulae.</p><p><b>RESULTS</b>Monitoring island abnormalities were indicated in 6 flaps, which accurately gave the alarm of the circulation crisis of the fibular graft. Surgical exploration was performed timely and the blood supply was recovered instantaneously. All the bone defects were healed at 6 months postoperatively. After 4 years of follow-up, all the grafted fibulae were thickened and were just like tibiae.</p><p><b>CONCLUSIONS</b>A monitoring island flap is a satisfactory method for repairing large defects of the long bones and a reliable method for assessing the vascular status of the grafted fibulae.</p>