シュラップネルから安定性へ: トラウマ後の70年,肘を完全に覆うためのリバース・パーフェレーター・フラップ. Aケースレポート Aケースレポート

Alvise Montanari¹, Cesare Tiengo¹, Alfio Luca Costa²

¹Plastic Surgery Unit, Department of Neuroscience, University of Padua, Padua 35121, Italy.

Military medicine

|February 12, 2026

まとめ

戦時中の弾丸の破片による負傷は,生涯にわたる肘の合併症を引き起こす可能性があります. デブリデメントとフラップの再建を含む積極的な手術は,高齢の患者の慢性骨髄炎と潰瘍を成功裏に治療しました.

科学分野:

整形外科整形外科
トラウマ・外科・外科
整形外科手術についてです.

背景:

幼少期の第二次世界大戦の弾丸の破片による負傷は,肘の骨折と神経の損傷につながった.
数十年後,患者は慢性的な骨髄炎を発症し,再発する頭蓋骨の潰瘍と傷痕の不安定さがありました.

研究の目的:

複雑な戦時シュラップネル傷害の生涯の管理を詳細に説明する.
慢性肘骨髄炎および柔らかい組織の欠陥に対する成功した外科再建を提示するために.

主な方法:

抗生物質による初期保守的な管理と,リポフィリングによる傷跡の修正.
フィスチュレクトミー,広範な骨解剖,および逆流の穿孔フラップによる軟組織再建を含む外科的介入.

主要な成果:

慢性潰瘍と骨髄炎の治癒に成功し,5年間の追跡調査で再発しなかった.
リバースフローの穿孔器のフラップは,困難な肘部領域の信頼性の高い,単段階の再構築オプションを提供しました.

結論:

戦争のトラウマによる慢性的な合併症は,患者の生涯を通じて現れます.
長期的な管理には,根本的な脱皮と堅固な軟組織再建を組み合わせた決定的な外科的アプローチが必要である.
ペディクルフラップは,肘の再構築を必要とする併発性疾患の高齢患者にとって有効な解決策です.

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