日本マイクロサージャリー学会会誌
Online ISSN : 2185-9949
Print ISSN : 0916-4936
ISSN-L : 2185-9949
症例
開放性橈骨遠位端骨折後の骨髄炎を伴う偽関節に対し血管柄付き肩甲骨および広背筋皮弁の合併組織移植を用いて治療した1例
宮永 亨島田 賢一柳下 幹男廣村 健太郎
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ジャーナル 認証あり

2021 年 34 巻 1 号 p. 10-15

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Infected pseudoarthrosis of the wrist after open radial fracture is difficult to treat and bone grafts are often necessary. We report the use of a scapula tip and latissimus dorsi free flap to treat infected pseudoarthrosis of the wrist. A 55-year-old male presented with a left open radial fracture (Gustilo typeⅢB) sustained while working with a forklift. Persistent deep infection developed after fracture fixation. A large skin and soft tissue defect remained on the left wrist. Split-thickness skin grafting was performed after controlling the infection. However, the patient developed pseudoarthrosis of the wrist and presented with pain, reduced hand function, and contracture of the hand and forearm. Parts of the proximal carpal bones and distal radius were removed, and the defect was reconstructed using a scapula tip and latissimus dorsi free flap.
Postoperatively, stabilization of the wrist joint, pain reduction, and improved hand function were observed. This case suggested that a scapula tip and latissimus dorsi free flap is an option for the treatment of carpal and radial bone defects involving skin and soft tissue defects.

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