Retrograde soleal muscle with periosteum-cortex bone flap for treatment of Gustilo type Ⅲ distal tibial fractures
10.3760/cma.j.issn.1001-8050.2012.06.010
- VernacularTitle:逆行比目鱼肌骨膜附皮质骨瓣治疗Gustilo Ⅲ型胫骨远端骨折
- Author:
Weiping WU
;
Shaohua LI
;
Jie LIU
;
Ming CAI
- Publication Type:Journal Article
- Keywords:
Tibia fractures;
Fracture fixation;
Soft tissue injuries;
Transplantation
- From:
Chinese Journal of Trauma
2012;28(6):520-523
- CountryChina
- Language:Chinese
-
Abstract:
Objective To design a new combination transplantation method for management of Gustilo type Ⅲ distal tibial fractures.Methods The study involved 46 patients with Gustilo type Ⅲ distal tibial fractures ( 16 patients with Gustilo type Ⅲa fractures and 30 with Gustilo type Ⅲ b fractures)treated with retrograde soleal muscle with periosteum-cortex bone flap grafting from October 1998 to November 2008.There were 29 males and 17 females at an average age of 36 years (range,23-77 years).After the complement of fracture fixation,the attachment point of the medial half of the soleal muscle to the upper tibia was exposed.The periosteum together with thin cortex bone flap on the surface of tibia was incised.The soleal muscle with pefiosteum-cortex bone flap was turned downwards to cover the bone and the soft tissue defects.Results All patients were followed up for average 26 months ( range,30-46 months).Nine patients were treated with autologous iliac grafts and the other 37 patients underwent periosteum-cortex bone flap grafting.The mean time of bone union was 22 weeks ( range,18-37 weeks).One patient had infection of external fixation pin tract.The ankle joint movement of 38 patients was recovered to a normal or nearly normal,but the other eight patients had limitation in the activity.All patients were able to walk normally after operation,but five patients felt powerless when running.Conclusions Retrograde soleal muscle with periosteum-cortex bone flap grafting is characterized by simple operation,simultaneous reconstruction of bone and soft tissue defects and promotion of fracture healing,and hence is a feasible and effective method to repair bone and soft tissue defects in Gustilo type Ⅲ distal tibial fractures.
