Objective: To evaluate one-stage repair of leg open fracture with soft tissue defect by fixation plus skin flap. Methods: From January 2011 to January 2018, 34 patients with leg open fracture plus soft tissue defect were treated at Department of Orthopedics, The Second Affiliated Hospital to Harbin Medical University. They were 31 males and 3 females, aged from 13 to 54 years(average, 35 years). According to the Gustilo classification, the defects were type ⅢA in 31 cases and type ⅢB in 3 cases. The wound size ranged from 6 cm×3 cm to 25 cm×10 cm. All patients were treated with emergency fracture fixation and flap repair by one stage after thorough debridement. Internal bone plating was performed in 32 patients and external fixation at a single arm in 2 patients. All defects were repaired with a free anterolateral thigh flap. Flap survival, vascular crisis and bone infection were followed up postoperatively. Results: All the free flaps survived in the 34 cases with no vascular crisis. These patients were followed up for 6 months to 3 years (average, 10 years). The flaps healed well, with good appearance and soft texture. No bone infection occurred at the defective sites. After postoperative rehabilitation, the knee extension ranged from 160° to 180°, knee flexion from 90° to 110°, ankle dorsal extension from 90° to 110°, and ankle plantar flexion from 100° to 120°. Conclusion Soft tissue defects in leg open fracture can be effectively treated by flap repair after thorough debridement at the same time of fracture fixation, because the primary wound healing can avoid infection and lead to fine survival of the flap.

Objective To observe the changes of metallothionein (M T) in the rat flap with ischemia-reperfusion injury. Methods A ri ght lower abdominal island flap was created in Wistar rats . 16 rats were random ly divided into two groups: the control ( n =8) and the ischemia-reperfusion injury group ( n =8). The contents of MT and malondialdehyde (MDA) were assaye d by 109 Cd-hemoglobin saturation and thiobarbituric acid (TBA) methods. Th e activity of myeloperoxidase (MPO) was measured by colorimetry. Results At ischemia 8 h, reperfusion 12 h and 24 h, the level of MDA in rat i schemia-reperfusion injury group increased 41.7 %, 111.4 %, and 135.7 %, the ac tivity of MPO increased 72.1 %, 218.9 % and 296.0 %, the content of MT increased 42.6 %, 52.8 % and 102.3 %, respectively, compared with the control group ( P