目的報告1例采用離斷的右足移位再植修復毀損左足的臨床效果。 方法2007年5月收治1 例火車碾壓致右踝及左前足離斷的患者,傷后8 h入院。急診手術將右小腿截肢,右足移位再植于左足。采用封閉式負壓引流技術治療未閉合創(chuàng)面,二期行游離植皮術。術后6個月右下肢安裝義肢。 結果患者移位再植的左前足成活,植皮區(qū)成活。術后5年隨訪,生活已同常人,可完全自理;左足第4、5趾感覺良好,兩點辨別覺約10 mm,第1、2、3趾感覺較差;踝關節(jié)活動度正常;按Sanders等提出的Maryland足功能評分標準評分為94分,達優(yōu)。 結論雙下肢離斷毀損傷移位再植術可保全患者一側肢體,并能獲得良好功能。
引用本文: 左坦坦,楊潤功. 雙下肢離斷毀損傷前足移位再植一例五年隨訪報告. 中國修復重建外科雜志, 2013, 27(1): 120-122. doi: 復制
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- 1. Sanders R, Fortin P, DiPasquale T, et al. Operative treatment in 120 displaced intraarticular calcaneal fractures. Results using a prognostic computed tomography scan classification. Clin Orthop Relat Res, 1993, (290): 87-95.
- 2. 王正義, 張建中, 俞光榮. 足踝外科學. 北京: 人民衛(wèi)生出版社, 2006: 604.
- 3. Daigeler A, Fansa H, Schneider W. Orthotopic and heterotopic lower leg reimplantation. Evaluation of seven cases. J Bone Joint Surg (Br), 2003, 85(4): 554-558.
- 4. Cinar C, Arslan H, Ogur S, et al. Crossover replantation of the foot after bilateral traumatic lower extremity amputation. Ann Plast Surg, 2007, 58(6): 667-672.
- 5. Fansa H, Frerichs O, Schneider W. Heterotopic replantatation after bilateral lower leg amputation. Chirurg, 2001, 72(11): 1369-1372.
- 6. Ricketts S, De Steiger R, Breidahl A. Eleven-year follow-up of cross-leg replantation for traumatic bilateral amputation. J Reconstr Microsurg, 2009, 25(2): 111-115.
- 7. 楊潤功, 張宇鵬. 負壓創(chuàng)面治療在骨科的應用研究進展. 中華外科雜志, 2010, 48(19): 1511-1513.