| 腓肠肌肌瓣转移治疗髌骨内固定术后感染 |
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投稿时间：2018-05-01 修订日期：2018-09-11
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
| DOI： |
| 基金项目:国家自然科学(81603644)；浙江省医药卫生一般研究项目(2016KYA057) |
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| 中文摘要:目的：探讨应用腓肠肌肌瓣治疗髌骨内固定术后感染的临床疗效。方法：自2011年1月至2017年1月收治髌骨内固定术后感染患者15例，其中男9例，女6例；年龄31～66（42.5±11.2）岁；病程2～8（4.3±1.5）个月。全部病例在病灶清除后应用腓肠肌肌瓣修复创面，肌瓣表面行游离植皮，供区直接缝合。术后观察肌瓣存活及切口愈合情况，末次随访时采用膝关节学会评分系统(KSS)进行膝关节功能评定。结果：所有肌瓣均顺利成活，无坏死。切口I期愈合13例，术后裂开2例，经换药治疗后愈合。15例均获9～30（20.6±8.3）个月的随访。术后感染无复发，肌瓣质地好，皮肤色泽与受区相似，外形良好。末次随访（术后9～30个月）KSS膝关节功能评分,其中临床评分为83.3±7.8，优7例，良6例，可2例；功能评分为86.3±10.4，优10例，良4例，可1例。结论：应用腓肠肌肌瓣转移治疗髌骨内固定术后感染，疗效稳定，复发率低，值得临床推广应用。 |
| 【关键词】腓肠肌肌瓣 髌骨 感染 创面 |
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| reatment of postoperative infection of patellar internal fixation with gastrocnemius muscle flap |
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| ABSTRACT Objective: To investigate the clinical effect of using gastrocnemius muscle flap for repairing the wound of postoperative infection of patellar internal fixation. Methods: From January 2011 to January 2017, 15 patients with postoperative infection of patellar internal fixation were treated, including 9 males and 6 females with an average age of 42.5±11.2 years ranging 31 to 66 years. The average course of disease was 4.3±1.5 months ranging 2 months to 8 months. All wounds were repaired by gastrocnemius muscle flap after debridement. The coverage of the muscle flap was performed by free skin graft and the donor site was closed directly. Postoperatively, observation of flap and incision, active rehabilitation were necessary. Finally, the knee functions were assessed by the KSS soccer criteria. Results: All muscle flaps survived without necrosis, 2 cases had wound dehiscence after operation and healed after symptomatic treatment, and the remaining wound healed for first intention. All patients were followed up for from 9 months to 30 months(means 20.6±8.3 months). No recurrence of infection was observed, the texture of muscle flap , skin color and the appearance were good. The average clinical score by KSS was（83.3±7.8) points, including 7 excellent cases,6 good cases,2 general cases. The average functional score by KSS was（86.3±10.4) points, including 10 excellent cases,4 good cases,1 general case. Conclusion: Gastrocnemius muscle flap is effective in repairing the wound of postoperative infection of patellar internal fixation with stable curative effect and low recurrence rate, and is worthy of promotion. |
| KEY WORDS gastrocnemius muscle flap patella infection wound |
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