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find Author "赵奎" 2 results
  • TREATMENT OF NONUNION OF TIBIA WITH SUPERFICIAL PERONEAL VASCULAR FASCIA PEDICEL TIBIOFIBULAR PERIOSTEAL FLAP

    Objective To investigate the surgical treatment method and the curative effect of tibial nonunion with superficial peroneal vascular fascia pedicel tibiofibular periosteal flap. Methods From January 1996 to December 2008, 18 cases of tibial nonunion were treated with superficial peroneal vascular fascia pedicel tibiofibular periosteal flap, interlockingintramedullary nail ing and cancellous bone graft of distal tibial. There were 14 males and 4 females, with an average age of 32.5 years old (range, 24-67 years old). Fracture site was middle in 10 cases and distal in 8 cases. Primary injury cause included 12 cases of traffic accident and 6 cases of bruise. The tibial nonunion reasons were manual reduction and plaster immobil ization in 8 cases, small spl int immobil ization in 4 cases, intramedullary nail fixation in 2 cases (no bone graft), plate fixation in 4 cases (including 3 cases of plate fixation and free il iac bone graft). Nonunion occurred after the first surgery. The time from nonunion to operation was 8 to 16 months, with an average of 10.5 months. The size of periosteal flap was 7 cm × 5 cm and distal tibial cancellous bone graft volume was 5-10 g. Results All incision achieved heal ing by first intention after operation without flap necrosis and infection. All patients were followed up 6-36 months with an average of 20.8 months. All tibial nonunion healed 5-7 months after operation. According to Johner-Wruh scoring, the results were excellent in 14 cases, good in 3 cases, and fair in 1 case; the excellent and good rate was 94.4%. Conclusion Superficial peroneal vascular tibiofibularfascia pedicel tibiofibular periosteal flap and interlocking intramedullary nail ing can attain good results in treating nonunion of tibia and fibula because of being stable internal fixation and promoting the heal ing of nonunion.

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
  • 桡侧副血管蒂肱骨远端骨膜瓣的临床应用

    目的 总结桡侧副血管蒂肱骨远端骨膜瓣治疗肱骨中下段骨不连的临床疗效,并与传统切开复位髓内钉内固定加自体髂骨植骨疗效进行比较。 方法 2002 年2 月- 2008 年6 月,对19 例肱骨中下段骨不连患者行桡侧副血管蒂肱骨远端骨膜瓣移位治疗(A 组),并与同期采用切开复位髓内钉内固定加自体髂骨植骨治疗的23 例(B 组)进行比较。A 组男13 例,女6 例;年龄24 ~ 63 岁,平均43.6 岁。手法复位石膏外固定后骨不连4 例,夹板固定后骨不连3 例,手术切开复位内固定后骨不连12 例。骨折至发生骨不连时间为6 ~ 16 个月,平均9 个月。B 组男15 例,女8 例;年龄29 ~ 71 岁,平均47 岁。手法复位石膏外固定后骨不连5 例,夹板固定后骨不连7 例,手术切开复位内固定后骨不连11 例。骨折时至发生骨不连的时间为7 ~ 18 个月,平均9.5 个月。 结果 术后切口均Ⅰ期愈合。两组患者均获随访,随访时间12 ~ 36 个月,平均20 个月。A 组于术后3 ~ 6 个月骨不连达骨性愈合,平均4.5 个月。B 组术后8 ~ 12 个月7 例再次发生骨不连,行桡侧副血管蒂肱骨远端骨膜瓣移位治疗,术后4 ~ 6 个月达骨性愈合;余患者均于术后4 ~ 7 个月达骨性愈合,平均5.5 个月。两组内固定均无松动断裂,肩肘关节功能恢复尚可。 结论 桡侧副血管蒂肱骨远端骨膜瓣移位结合髓内钉内固定及植骨是一种治疗肱骨中下段骨不连的有效方法。

    Release date:2016-09-01 09:08 Export PDF Favorites Scan
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