分期综合保肢救治双下肢严重毁损伤1例

王光楠, 魏永兴, 李垒, 李高山, 于万军, 黄丽, 陈艳

武警医学 ›› 2026, Vol. 37 ›› Issue (2) : 168-170.

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武警医学 ›› 2026, Vol. 37 ›› Issue (2) : 168-170.
临床经验总结

分期综合保肢救治双下肢严重毁损伤1例

  • 王光楠, 魏永兴, 李垒, 李高山, 于万军, 黄丽, 陈艳
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摘要

高能量创伤导致的Gustilo ⅢC型开放性胫骨骨折合并双侧小腿肌肉广泛缺失(>80%)及胫骨毁损伤的保肢决策极具挑战性。本文报告1例双下肢被载重汽车碾压后导致左侧Gustilo ⅢC型、右侧Gustilo ⅢB型胫骨骨折,肢体损伤严重度评分(MESS)分别为12分(左侧)和10分(右侧),双侧小腿肌肉坏死缺失>80%,合并左侧腘动脉断裂、双侧胫神经和腓总神经损伤。采用分期综合保肢策略,双侧肢体均成功保留,术后随访1年4个月,患肢感觉功能和负重功能恢复良好,未见慢性溃疡、骨髓炎等远期并发症,获得满意的临床效果。

关键词

胫骨骨折 / 负压伤口治疗 / 肌瓣 / 保肢 / Gustilo分型

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王光楠, 魏永兴, 李垒, 李高山, 于万军, 黄丽, 陈艳. 分期综合保肢救治双下肢严重毁损伤1例[J]. 武警医学. 2026, 37(2): 168-170
中图分类号: R683.42   

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基金

辽宁省自然科学基金项目(2023-MSLH-351);吴阶平医学基金会科研专项资助项目(320.6750.2025-06-297)

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