MICROVASCULAR SOFT-TISSUE TRANSPLANTATION FOR RECONSTRUCTION OF ACUTE OPEN TIBIAL FRACTURES - TIMING OF COVERAGE AND LONG-TERM FUNCTIONAL RESULTS
MICROVASCULAR SOFT-TISSUE TRANSPLANTATION FOR RECONSTRUCTION OF ACUTE OPEN TIBIAL FRACTURES - TIMING OF COVERAGE AND LONG-TERM FUNCTIONAL RESULTS
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DOI：
10.1097/00006534-199203000-00014
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发表时间：
1992-03-01
影响因子：
3.6
通讯作者：
YAREMCHUK, MJ
中科院分区：
文献类型：
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作者：
FRANCEL, TJ;VANDERKOLK, CA;YAREMCHUK, MJ
72例Gustilo IIIB级开放性胫骨骨折患者采用游离组织转移治疗。 如果在受伤后15天内成功进行软组织重建的游离组织移植，严重并发症的风险为3.6%。 长期回顾性随访（平均42个月）显示，93%的患者成功保肢，80%的患者获得良好的美学效果，96%的患者满意。 然而，66%的患者表现出踝关节活动范围明显减少，44%的患者出现肿胀和水肿，需要弹性支撑和活动调整，50%的患者偶尔需要辅助设备进行截肢。 长期就业率为28%，失业2年后没有病人重返工作岗位。 相比之下，68%的下肢创伤后截肢者在两年内重返工作岗位。 患者需要意识到这种伤害对他们的家庭，工作和未来的破坏性。
Seventy-two patients with Gustilo grade IIIB open tibial fractures were treated with free-tissues transfers. If successful free-tissue transfer for soft-tissue reconstruction is performed within 15 days of injury, the risk of major complications is 3.6 percent. Long-term retrospective follow-up (mean 42 months) revealed successful limb salvage in 93 percent, good aesthetic results in 80 percent, and patient satisfaction in 96 percent. However, 66 percent of patients exhibited significantly decreased range of motion of the ankle, 44 percent experienced swelling and edema requiring elastic support and activity modification, and 50 percent occasionally required an assistance device for ambulation. The long-term employment rate was 28 percent, and no patient returned to work after 2 years of unemployment. In contrast, 68 percent of amputees after lower extremity trauma over the same period returned to work within 2 years. Patients need to realize the disruptive nature of this injury on their family, job, and future.