双下肢离断毁损伤前足移位再植一例五年随访报告_Chinese Journal of Reparative and Reconstructive Surgery

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左坦坦 , 杨润功

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Keywords：

移位再植术; 前足; 肢体离断; 封闭式负压引流技术

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目的报告1例采用离断的右足移位再植修复毁损左足的临床效果。方法2007年5月收治1 例火车碾压致右踝及左前足离断的患者，伤后8 h入院。急诊手术将右小腿截肢，右足移位再植于左足。采用封闭式负压引流技术治疗未闭合创面，二期行游离植皮术。术后6个月右下肢安装义肢。结果患者移位再植的左前足成活，植皮区成活。术后5年随访，生活已同常人，可完全自理；左足第4、5趾感觉良好，两点辨别觉约10 mm，第1、2、3趾感觉较差；踝关节活动度正常；按Sanders等提出的Maryland足功能评分标准评分为94分，达优。结论双下肢离断毁损伤移位再植术可保全患者一侧肢体，并能获得良好功能。

Citation： 左坦坦,杨润功. 双下肢离断毁损伤前足移位再植一例五年随访报告. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(1): 120-122. doi: Copy

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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. 王正义, 张建中, 俞光荣. 足踝外科学. 北京: 人民卫生出版社, 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. 杨润功, 张宇鹏. 负压创面治疗在骨科的应用研究进展. 中华外科杂志, 2010, 48(19): 1511-1513.

Chinese Journal of Reparative and Reconstructive Surgery

双下肢离断毁损伤前足移位再植一例五年随访报告

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