摘要目的 探讨严重小腿离断伤再植方法及其后续功能重建的方法,并观察其疗效. 方法 回顾性研究2013年2月至2017年10月解放军第九六○医院骨创伤外科收治的13例严重小腿离断伤患者资料,男10例,女3例;年龄15～63岁,平均39岁;均一期行大段短缩再植,二期行Ilizarov肢体延长技术,待延长满意后,拆除Ilizarov外固定支架,闭合下应用锁定钢板外置固定.术后观察膝踝关节功能,足底感觉恢复情况,肢体长度及外观. 结果 13例患者术后均获随访,时间12 ～24个月,平均16个月.均再植成活,患肢成活良好,12例患者感觉满意.短缩再植患者均获成活,负重行走满意. 结论 严重小腿离断创面通过一期短缩再植治疗可以获得良好的保肢效果,二期行Ilizarov肢体延长重建术可以取得良好的疗效.

abstractsObjective To evaluate our replantation and functional reconstruction of amputated lower extremities.Methods From February 2013 to October 2017,13 patients with an amputated lower extremity were treated at Orthopaedic Department,The 960th Hospital of the PLA Joint Logistics Support Force.They were 10 males and 3 females,aged from 15 to 63 years (average,39 years).In all the patients,large segmental shortening and extremity replantation was conducted at the first stage and Ilizarov extremity lengthening at the secondary stage.After desired extension was achieved,the frame of Ilizarov external fixator was removed and replaced by external fixation with a locking plate under closed reduction.Postoperatively,functions of the knee and ankle joints,sensory recovery of the foot sole,length and appearance of the extremity were observed.Results All the 13 patients were followed up for 12 to 24 months (average,16 months).All the limb replants survived well.Of them,12 were satisfied with their weight-bearing walking and therapeutic outcomes.Conclusions For an amputated lower extremity,the first-stage shortening and replantation can result in fine extremity salvage and the secondary Ilizarov extremity lengthening can lead to fine therapeutic outcomes.