【摘 要】 目的 改进切取带血管腓骨及其复合组织瓣游离移植修复胫 骨缺损合并胫前及周围皮肤软组织缺损的方法。方法 采用改进法 行带血管腓骨及复合组织皮瓣的切取，术中先锯断两端腓骨，再切取带肌袖腓骨和显露腓动 、静脉血管蒂。为确保游离移植腓骨的血运，腓动脉两断端均与受区胫前动脉吻合。结果 术中无一例损伤腓动、静脉，切取腓骨时间为20～40分钟。术后16 例移植腓骨均Ⅰ期愈合，骨愈合时间为2～3个月。随访6个月～9年3个月，14例患肢功能 恢复正常，16例供腓骨侧均无踝关节不稳定发生。结论 该改进法 切取腓骨具有手术出血量少、解剖清晰及手 术时间较常规方法明显缩短的优点。腓骨复合组织瓣移植法行植骨的同时修复胫前皮肤软组 织缺损，并可对移植腓骨的血运情况进行监测。

APPLICATION OF REPAIRING TIBIA AND SOFT TISSUE

    DEFECT WITH FREE FIBULA COMBINED TISSUE GRAFTING

ZHEN Ping,LIU Xing-yan ,WEN Yi-min,et al

    .Center of Orthopedic Surgery,General Hospital of PLA of Lan zhou.Lanzhou Gansu, P.R.China 730050

【Abstract】 Objective To investigate a good method for repairing the long bone defect of tibia con bined with soft tissue defect.Methods From 1988～1998, sixteen p atients with long bone defect of tibia were admitted. There were 12 ma les, 4 females and aged from 16 to 45 years. The length of tibia defect ranged f rom 7 cm to 12 cm, the area of soft tissue defect ranged from 5 cm×3 cm to 12 cm×6 cm .Free fibula grafting was adopted in repairing. During operation, the two ends o f fibular artery were anastomosised with the anterior tibial artery of the recipi ent, an d the composited fibular flap were transplanted.Results A ll grafted fibula unioned and the flap survived completely.Followed up for 6 to 111 months,14 patients acquired the normal function while the other 2 patients recei ved arthrodesis of the tibial-talus joint. In all the 16 patients,the unstable ankle joint could not be observed .Conclusion The modified method is characterized by the clear anatomy, the less blood loss and the reduced operation time. Meanwhile,the blood supply of the grafted f ibula can be monitored.

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