Epidemiological profile and treatment of substance losses by trauma to the lower limbs

ABSTRACT Objectives: to evaluate the epidemiological profile, the surgical treatment and the postoperative results of patients with complex traumatic injuries to the lower limbs. Methods: we conducted a retrospective study of patients with traumatic complex injuries treated by the Plastic Surgery Service of a regional hospital in Brasília. We analyzed clinical-epidemiological data, type of surgical procedure and functional recovery of the limb after six months of treatment. Results: 119 patients were treated, with a mean age of 29 years, predominantly men (76.4%). Motorcycle accident was responsible for most of the injuries, in 37.8% of cases. The most frequent surgical treatment was skin grafting (62.1%), followed by the fasciocutaneous flap (21.9%), muscular flap (12.6%) and microsurgical flap (3.4%). Six months after completion of the surgical treatment, 35.3% of the patients needed crutches to move, characterizing a delay in limb functional recovery that, however, was significantly related to the presence of fractures, external fixation or bone exposure in the preoperative period. Conclusion: the profile of the patient with complex traumatic lower limb injury was a male, motorcycle accident victim, and grafting was the most used treatment. Orthopedic trauma with bone fracture, bone exposure and the presence of external fixator were significantly associated with a higher risk of limb functional impairment, requiring locomotion crutches after six months of treatment.

摘要
研究目的：评估下肢复杂创伤患者的流行病学特征、手术治疗方案及术后转归。
方法：本研究为回顾性研究，纳入巴西利亚某区域医院整形外科收治的复杂下肢创伤患者，分析其临床流行病学资料、手术类型及治疗6个月后的肢体功能恢复情况。
结果：共纳入119例患者，平均年龄29岁，以男性为主（占比76.4%）。摩托车事故为最主要的致伤原因，占比37.8%。最常用的手术治疗方式为皮肤移植（skin grafting），占比62.1%，其次为筋膜皮瓣（fasciocutaneous flap）术（21.9%）、肌皮瓣（muscular flap）术（12.6%）及显微外科皮瓣（microsurgical flap）术（3.4%）。手术治疗完成后6个月，35.3%的患者仍需借助拐杖行走，提示存在肢体功能恢复延迟；该延迟与术前合并骨折、外固定装置或骨外露情况显著相关。
结论：下肢复杂创伤患者以男性摩托车事故伤者为主，皮肤移植为最常用的治疗手段。术前合并骨折、骨外露及外固定支架者，术后6个月出现肢体功能受损、需借助拐杖行走的风险显著升高。