Application of vascularized fibular flap combined with vacuum sealing drainage in the repair of long tibia defect
10.3969/j.issn.1005-6483.2017.03.020
- VernacularTitle:带血管蒂腓骨骨皮瓣移植联合负压封闭引流治疗胫骨长段骨缺失的临床应用
- Author:
Yi ZHOU
;
Jinhai TAN
- Keywords:
tibia defect;
fibular flap;
vacuum sealing drainage;
chronic osteomyelitis
- From:
Journal of Clinical Surgery
2017;25(3):222-225
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effects of vascularized fibular flap combined with vacuum sealing drainage (VSD) in the repair of tibia defect.Methods Clinical data of 24 patients with chronic osteomyelitis of the tibia who accepted the operation of vascularized fibular flap combined with VSD were collected in the study.In the first operation, the lesions were completely debrided and the dead bone was removed, then the vascularized fibular was replaced from the other limb to repair the tibia defect.Later, vacuum-assisted closure was applied to cover the wound.Results All patients enrolled in the study were followed up for 13 to 50 months, with an average of 32.3 months.The sinus of 22 cases healed in 4 weeks and the healing rate was 91.7%.The other two patients received additional debridement for the sinus and they also healed soon after that.All flaps survived and the survival rate was 100%.The X-ray showed that the transplanted fibula was healed in all cases, with a healing rate of 100%.The healing time ranged from 4 to 7 months, with an average of 4.9 months.Based on the Enneking scoring system, the patients achieved an average score of 26 points out of 30 points, and the recovery rate of limb function was evaluated as 86.7%.Conclusion For patients with chronic osteomyelitis of the tibia, vascularized fibular flap combined with VSD can not only effectively repair bone defect, but also restore the continuity of limbs.The application of VSD can effectively control infection, shorten treatment course, and restore limb function.
