骨在下肢重建中的使用-我们从49个案例中学到的东西
Michael Rice1, Thomas Wright1, George Wheble1
1Department of Plastic and Reconstructive Surgery, Southmead Hospital, North Bristol NHS Trust, Southmead Road, Bristol BS10 5NB, United Kingdom.
Injury
|June 13, 2024
概括
骨 (PB) 肌肉是老年患者复杂下肢缺陷的可靠,单阶段解决方案. 这项研究发现百分之百的片存活率,提供了一个具有成本效益的重建选项.
科学领域:
- 整形外科手术 整形外科手术
- 重建性手术是一种重建性手术.
- 微手术 微手术是一种微手术.
背景情况:
- 在伴随疾病的老年患者中治疗软组织缺陷存在挑战,因为它们不适合长时间或多阶段的手术.
- 在这个患者队列中,复杂的,横向的下肢缺陷存在有限的重建选择.
- 腹肌 (PB) 肌为此类具有挑战性的病例提供了一个单阶段的替代方案.
研究的目的:
- 评估使用PB肌肉用于下肢重建的疗效和结果.
- 评估这种单阶段手术在具有挑战性的患者群体中的可行性.
- 确定与PB片重建相关的好处和风险.
主要方法:
- 一项回顾性研究对使用PB片进行下肢重建的患者进行.
- 收集的数据包括患者人口统计学,并发症,缺陷特征,外科手术期间的细节和结果.
- 评估的变量:片存活率,患者发病率/死亡率,住院时间和功能评分.
主要成果:
- 在2015-2023年期间,49名患者接受了PB重建;42名患者接受了PB和皮肤移植,7名患者接受了额外的技术.
- 指示包括感染骨折后固定 (n=28) 和开放创伤 (n=21). 平均年龄为59岁,ASA等级为3.
- 实现了100%的翻盖存活率,平均Eneking分数为65;没有发现异型骨化.
结论:
- PB肌肉是一个可靠和成本效益的单阶段技术,用于重建下肢远端三分之一的小侧面缺陷.
- 它为老年患者的复杂缺陷提供了可行的解决方案,这些缺陷通常不适合其他方法.
- 该研究强调了益处和风险,并主张在特定情况下使用它.
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