Composite bone and skin flap transplantation combined with bone lengthening for repairing lower limb burn with soft tissue and bone defect

Abstract

To compare the effect of traditional fibula flap combined with allogeneic bone transplantation and composite bone flap transplantation combined with bone lengthening in staged repair of severe soft tissue and bone defect caused by lower limb burn. Total 68 patients with severe soft tissue and bone defect caused by lower limb burn from March 2015 to January 2018 were retrospectively analyzed, and they were divided into control group (34 cases) and study group (34 cases) according to the treatment plan. All patients had different degrees of soft tissue and bone tissue defects. In the study group, 34 patients were treated with composite bone flap transplantation combined with bone lengthening. There were 22 males and 12 females; the age ranged from 32 to 46(39.18±6.01) years; the time from injury to treatment was (16.69±5.11) h;28 cases were caused by explosion injury and 6 cases were caused by firearm burn; the length of bone defect was (12.10± 2.34) cm;and 16 cases were on the left side of affected limb 18 cases were on the right side. In the control group, there were 24 males and 10 females, aged 31 to 47 (38.93 ± 5.81) years;the time from injury to treatment was(17.10±5.63) h;the causes of injury were explosive injury in 30 cases and firearm burn in 4 cases; the length of bone defect was (11.96±2.51) cm;19 cases were on the left side and 15 cases on the right side. All patients were followed up for 6 months. The FMA scores before operation and 3 and 6 months after operation, treatment satisfaction, curative effect and complications of the two groups were recorded. Limb function:there was no significant difference in FMA scores between the two groups before operation (P> 0.05), and the FMA scores of the two groups were higher than those before operation 3 and 6 months after operation(P<0.05), and the FMA scores of the studygroup were higher than those of the control group (P<0.05). At 6 months after operation:the excellent and good rate of the study group (94.12%) was higher than that of the control group (76.47%)(P<0.05), the treatment satisfaction of the study group (94.12%) was higher than that of the control group(76.47%)(P<0.05). Complications:the incidence of complications in the study group (14.71%) was higher than that in the control group (26.47%) (P>0.05). the combined use of composite bone flap transplantation and bone lengthening staged repair in the treatment of severe soft tissue and bone defect caused by lower limb burn can achieve good therapeutic effect, improve limb function, and have high treatment satisfaction and certain safety.