One stage reconstruction of limb injuries caused by high energy in 55 patients / 中华创伤杂志

ABSTRACT

Objective To report the clinical results of one stage reconstruction of high-energyinjured limbs. Methods From January 2001 to July 2006,one stage reconstruction was done on 55patients suffered from massive limb trauma,severe open fractures or spoiled limbs caused by high energy.There included 16 patients with Gustilo Type-Ⅲ C fractures,with mangled extremity severity score (MESS)of(6.25 ±2.53)points.All patients were treated with transplantation of free flaps or pedicle skin flaps,fracture fixation,nerve reconstruction or functional reconstruction. Results All limbs were saved and all flaps were transplanted successfully.without protracted course to obtain soft tissue coverage.The hospitalization was mean 24 days(12-63 days)and follow-up ranged from 12 months to 50 months (averaged 23 months).Complications including wound infection,bone nonunion,necrosis and morbidity were significanfly less likely to appear than conventional ways and the ultimate functional results of the saved limbs were at least better than that of artificial ones. Conclusions In comparison with traditional methods,one stage reconstruction of severe high energy-injured limbs has advantages of easier justification of tissue structure,better match of donor and recipient blood vessels,easier operation design,shorter hospitalization and better functional recovery.Definitive wound closure with vascularised tissue transfer can facilitate local blood supply.decrease bone infection and hence promote bone healing.