Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2026 Oct 15;40(10):1541-1547. doi: 10.7507/1002-1892.202608021.
ABSTRACT
OBJECTIVE: To investigate the effectiveness of Ilizarov soft-tissue distraction combined with debridement and dressing changes in the treatment of chronic limb wounds after popliteal artery injury.
METHODS: A retrospective analysis was conducted on the clinical data of 24 patients with chronic limb wounds after popliteal artery injury who were admitted between January 2023 and June 2025 and met the selection criteria. There were 15 males and 9 females, aged 24-79 years (mean, 52.6 years). Causes of injury included traffic accident injury in 16 cases, mechanical injury in 6 cases, and fall from height in 2 cases. The time from injury to revascularization ranged from 4 to 16 hours (mean, 9.6 hours). There were 29 wounds in total, with wound sizes ranging from 3 cm×2 cm to 12 cm×9 cm. Among them, 18 wounds in 16 patients were persistent chronic wounds after injury, and 11 wounds in 8 patients were recurrent muscle liquefaction wounds after healing of the limb soft tissue. Wound reconstruction was performed sequentially using debridement, continuous dressing changes, Ilizarov soft-tissue distraction, and other methods. The external fixation configuration for soft-tissue distraction was individually assembled according to wound location and morphology. Wound healing, limb salvage rate, complications, and limb functional recovery were observed.
RESULTS: Of the 29 wounds in 24 patients, 28 ultimately healed, with a healing rate of 96.6%. Limb salvage was successful in 23 patients, with a limb salvage rate of 95.8%; 1 patient underwent amputation due to severe ischemic necrosis of the limb caused by thrombosis, with an amputation rate of 4.2%. All patients were followed up 12-29 months (mean, 24.1 months); 17 had more than 2 years of follow-up. The Hospital for Special Surgery (HSS) score was 58-85 (mean, 72.4); Lower Extremity Functional Scale (LEFS) score was 32-68 (mean, 58.6). Twenty-two patients recovered two-point discrimination (range, 10-40 mm), and 2 patients recovered protective sensation.
CONCLUSION: Ilizarov soft-tissue distraction technique combined with debridement and dressing changes can effectively promote the healing of chronic limb wounds after popliteal artery injury, improve the limb salvage rate and limb function, representing a feasible treatment strategy.
PMID:42896994 | DOI:10.7507/1002-1892.202608021