Application of bone transmission and fascia skin flap recover large defeciency of bone and soft tissue of lower limb / 中国矫形外科杂志

ABSTRACT

[Objective]To research the effect of using Ilizarov technique in bone transmission and fascia skin flap for large defeciency of bone and soft tissues of lower limb.[Method]There were 12 patients in our group,11 patients had severe compound trauma of the leg,one in arm.Bone defeciency range was 4～12 cm,average 8 cm,cotaneous defeciency was 4?5 cm2～14?5 cm2,and all of them had acute infection.Nine had been treated with leg lateral fascia skin flap,1 had been treated with leg fascia skin flap,1 had been treated with the opposide leg skin flap,1 had been treated with the arm fascia skin flap,in 12 bone transport,elongation range was 4～12 cm,average 8 cm.Eight had been used double arms external fixation device,4 cases had been used circle shape external fixation device.[Result]Totally 12 patients were followed up for 2～10.8 years(average,4.2 years) elongation part and compressed part healed naturally,all of the fascia shin flap were alive.No bone ununion and chronic osteomyelitis appeared.[Conclusion]Using Ilizarov bone transport technique and fascia skin flap is a good way for treating large defeciency of bone and soft tissue.Its advantages(1)The wound limb can maintain stability by external fixatian device.The methed of the bone transportation can fill big section bone deficiency;(2) In the same time the fascia shin flap may be transported,and repair soft tissue deficiency,provide good condition to bone's healing and control infection;(3)The external fixation device can provide distraction and compression functions,this function makes elongation part and compressed part obtain the reasonable biomechanics condition which would be good to bone healing;(4)The course of bone transmission can stimulate bone repair mechanisms,to enhance the wound limb metabolism,increase blood supply circularation,the grown bone factor aggregation,enhance the body's initiative repair mechanisms and infection controlling mechanism;(5)In the protection of the external fixation device,the patient's wound limb can do early rehabilitation,thus can avoid osteoporosis and joint dyfunction because of the lone-term immobility;(6)To use these methods,the treatment period will be shortened,antibiotic application will be decreased,the treatment cost will be lower than other methods and complications will be decreased as well.