前腕レベルの重度上肢外傷4例の治療経験

抄録

  The importance of soft tissue reconstruction using early free tissue transfer for severe injuries of the upper extremity to restore and maintain limb function has been reported. In this study, we report four cases of severe injuries of the upper extremity at the forearm level in which soft-tissue reconstruction using early free tissue transfer was performed, with a review of the literature. Two patients who underwent free tissue transfer within 72 hours of injury did not develop wound infection during the course of the procedure, whereas two patients who did not undergo reconstruction developed wound infection. Wound healing, time to bone union, and hospitalization were all prolonged in the two patients who did not undergo early free tissue transfer. Soft tissue defects in severe trauma to the forearm require blood-rich soft tissue coverage of exposed bone, tendons, and nerves, even if the extent of necrosis is small, and secondary complications such as soft tissue necrosis and deep infection are probable. It is important to perform soft tissue reconstruction using free tissue transfer within 2-3 days, if the patient’s general condition permits.