腓肠肌远端皮瓣修复小腿和足部创伤性骨髓炎后软组织缺损-动脉网

Distally based sural flaps for soft tissue defects following traumatic osteomyelitis of lower leg and foot

Nature 等信源发布 2024-10-05 21:47

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AbstractThis retrospective study aimed to determine the incidence and risk factors for osteomyelitis recurrence and present our experiences in treating traumatic osteomyelitis in the lower leg and foot. We retrospectively reviewed data from 174 patients with distally based sural flaps for treating traumatic osteomyelitis with soft tissue defects in the lower leg and foot from November 2003 to February 2021.

摘要这项回顾性研究旨在确定骨髓炎复发的发生率和危险因素，并介绍我们治疗小腿和足部创伤性骨髓炎的经验。我们回顾性分析了2003年11月至2021年2月期间174例远端腓肠肌皮瓣治疗小腿和足部软组织缺损的创伤性骨髓炎患者的资料。

Possible risk factors for osteomyelitis recurrence were compared between the osteomyelitis control and recurrence groups. A total of 162 (93.1%) flaps survived uneventfully, while 12 (6.9%) flaps developed partial necrosis. Five patients had a bone defect with an average length of 5 cm. The free vascularized bone grafts were performed in two patients, and bone transportations were performed in three patients.

比较骨髓炎对照组和复发组之间骨髓炎复发的可能危险因素。共有162个（93.1%）皮瓣存活良好，而12个（6.9%）皮瓣出现部分坏死。五名患者的骨缺损平均长度为5厘米。两名患者进行了游离血管化骨移植，三名患者进行了骨运输。

All patients were followed up with an average period of 72.8 months. There were 152 patients (87.4%) in control group and 22 patients (12.6%) in recurrence group. The recurrence rates of osteomyelitis were significantly higher when the patient’s age was 40 years or more and the duration was 10 weeks or more (P < 0.05).

所有患者均获得随访，平均随访72.8个月。对照组152例（87.4%），复发组22例（12.6%）。当患者年龄为40岁或以上，持续时间为10周或更长时，骨髓炎的复发率显着更高（P<0.05）。

Cierny-Mader (C-M) classification type IV osteomyelitis was also significantly associated with osteomyelitis recurrence (p = 0.049). This flap combined with appropriate osteomyelitis treatment was an effective method to treat traumatic osteomyelitis of lower leg and foot with a soft tissue defect. Both patient age ≥ 40 years old and C-M type IV osteomyelitis were nonnegligible risk factors for osteomyelitis recurrence..

Cierny-Mader（C-M）分类IV型骨髓炎也与骨髓炎复发显着相关（p=0.049）。该皮瓣结合适当的骨髓炎治疗是治疗小腿和足部创伤性骨髓炎伴软组织缺损的有效方法。患者年龄≥40岁和C-M IV型骨髓炎都是骨髓炎复发的不可忽视的危险因素。。

IntroductionInjuries of the limbs are becoming increasingly frequent with the rapid development of industries and transportation. It has been reported that 5–50% of open injuries end in bone infections1. These open injuries easily cause skin parenchyma deficiency after the soft tissue undergoes severe trauma in the anterior part of the lower leg and foot, especially when the wounds are accompanied by heavy pollution.

引言随着工业和交通的快速发展，四肢受伤越来越频繁。据报道，5-50%的开放性损伤以骨感染告终1。这些开放性损伤在小腿和足部前部的软组织受到严重创伤后，特别是当伤口伴有严重污染时，很容易导致皮肤实质缺陷。

The lower leg and foot tend to develop bone exposure and traumatic osteomyelitis followed by soft tissue defects and infections.The literature indicates several techniques to successfully treat osteomyelitis. Aggressive debridement is the basic treatment. Inadequate debridement is one reason for high recurrence rates2.

小腿和足部往往会出现骨骼暴露和创伤性骨髓炎，然后是软组织缺损和感染。文献指出了几种成功治疗骨髓炎的技术。。清创不足是复发率高的原因之一2。

The induced membrane technique, bone transport and free vascularized bone transplantation have been used to reconstruct large bone defects after osteomyelitis debridement3,4. Antibiotic sustained-release systems and bioglass have also been used to eradicate the dead space followed by removal of the sequestra in the osteomyelitis5.

诱导膜技术，骨运输和游离血管化骨移植已被用于重建骨髓炎清创术后的大骨缺损3,4。抗生素缓释系统和生物玻璃也被用于根除死腔，然后去除骨髓炎中的螯合物5。

Many kinds of flaps, such as local flaps, pedicled flaps, free flaps and perforator flaps, have been used to treat osteomyelitis with soft tissue defects6,7,8,9.In 1992, Masquelet et al.10 described the anatomical characteristics and clinical applications of the distally based sural flap, which has been widely used to reconstruct the lower leg and foot11,12,13,14.

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The distal sural flap combined with osteomyelitis treatment technology has been reported to treat traumatic osteomyelitis in the lower leg and foot with soft tissue defects15,16, while few reports have focused on a large sample and long follow-up period. This retrospective study aimed to determine both the incidence and risk factors for osteomyelitis recur.

。这项回顾性研究旨在确定骨髓炎复发的发生率和危险因素。

Data availability

数据可用性

Data used or analyzed during this study are included in the article. Detailed datasets are available from the corresponding author on reasonable request.

本文包含了本研究中使用或分析的数据。根据合理的要求，通讯作者可以提供详细的数据集。

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Download referencesFundingThis work was supported by the Natural Science Foundation of Hunan Province, Grant numbers: 2022JJ30852.Author informationAuthors and AffiliationsDepartment of Orthopedics, Hunan University of Medicine General Hospital, Huaihua, 418000, Hunan, People’s Republic of ChinaShunhong Luo & Shimu ShiDepartment of Orthopedics, The Second Xiangya Hospital, Central South University, No.

下载参考文献资助这项工作得到了湖南省自然科学基金的支持，资助号：2022JJ30852。作者信息作者和所属单位湖南医科大学总医院骨科，怀化，418000，湖南，中华人民共和国罗顺红和石木石中南大学湘雅第二医院骨科，No。

139 Renmin Road, Changsha, 410011, Hunan, People’s Republic of ChinaShunhong Luo, Yingliang Jiang, Zhonggen Dong, Xiao Peng, Shimu Shi, Zhaobiao Luo, Shibin Tao & Jianwei WeiAuthorsShunhong LuoView author publicationsYou can also search for this author in.

中华人民共和国湖南省长沙市人民路139号罗顺红、蒋英良、董仲根、肖鹏、石木石、罗兆彪、陶世斌和魏建伟作者罗顺红观点作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarYingliang JiangView author publicationsYou can also search for this author in

PubMed Google ScholarYingliang JiangView作者出版物您也可以在

PubMed Google ScholarZhonggen DongView author publicationsYou can also search for this author in

PubMed Google ScholarZhonggen DongView作者出版物您也可以在

PubMed Google ScholarXiao PengView author publicationsYou can also search for this author in

PubMed谷歌学者肖鹏查看作者出版物您也可以在

PubMed Google ScholarShimu ShiView author publicationsYou can also search for this author in

PubMed Google ScholarShimu ShiView作者出版物您也可以在

PubMed Google ScholarZhaobiao LuoView author publicationsYou can also search for this author in

PubMed谷歌学者赵彪罗维尤作者出版物您也可以在

PubMed Google ScholarShibin TaoView author publicationsYou can also search for this author in

PubMed Google ScholarShibin TaoView作者出版物您也可以在

PubMed Google ScholarJianwei WeiView author publicationsYou can also search for this author in

PubMed谷歌学者Jianwei WeiView作者出版物您也可以在

PubMed Google ScholarContributionsAll authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by S.H.L., Y.L.J., Z.G.D., X.P., S.M.S., Z.B.L., S.B.T. and J.W.W. The first draft of the manuscript was written by S.H.L.

PubMed谷歌学术贡献所有作者都为研究概念和设计做出了贡献。材料准备，数据收集和分析由S.H.L.，Y.L.J.，Z.G.D.，X.P.，S.M.S.，Z.B.L.，S.B.T.和J.W.W.进行。手稿的初稿由S.H.L.撰写。

and J.W.W., and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.Corresponding authorCorrespondence to.

和J.W.W.，以及所有作者都对手稿的以前版本发表了评论。所有作者都阅读并批准了最终稿件。对应作者对应。

Jianwei Wei.Ethics declarations

魏建伟。道德宣言

Competing interests

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The authors declare no competing interests.

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Reprints and permissionsAbout this articleCite this articleLuo, S., Jiang, Y., Dong, Z. et al. Distally based sural flaps for soft tissue defects following traumatic osteomyelitis of lower leg and foot.

转载和许可本文引用本文Luo，S.，Jiang，Y.，Dong，Z。等人，远端腓肠肌皮瓣治疗小腿和足部创伤性骨髓炎后的软组织缺损。

Sci Rep 14, 23214 (2024). https://doi.org/10.1038/s41598-024-73492-8Download citationReceived: 05 October 2023Accepted: 18 September 2024Published: 05 October 2024DOI: https://doi.org/10.1038/s41598-024-73492-8Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1423214（2024）。https://doi.org/10.1038/s41598-024-73492-8Download引文接收日期：2023年10月5日接收日期：2024年9月18日发布日期：2024年10月5日OI：https://doi.org/10.1038/s41598-024-73492-8Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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