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[目的]探讨应用桥式皮瓣移植结合Ilizarov技术治疗GustiloⅢ-B、C型毁损性小腿损伤的临床疗效.[方法] 2008～2015年对肢体严重外伤后伤肢仅残留一根主干血管或虽残留2根或以上主干血管,但因伤肢创面周围发生严重的炎性组织反应,找不到血管蒂可与皮瓣血管蒂吻合的临床病例22例.年龄10～56岁,平均32.6岁;男14例、女8例;左侧10例,右侧12例;交通伤12例,机器伤10例.全部应用股前外侧皮瓣移植覆盖创面,皮瓣血运重建采用将皮瓣血管蒂旋股外侧动脉的近端“Y”形血管分叉“嵌入”.在健侧胫后动脉两断端之间吻合.肢体软组织缺损面积10 cm×20 cm～ 18 cm×32 cm.骨缺损患者22例,胫骨缺损最长18 cm、最短10 cm,22例骨缺损患者全部应用Ilizarov技术牵拉成骨修复长段骨缺损.在骨段滑移完成后断端少量植骨4例.[结果]22例皮瓣全部成活,无血管危象发生,3～4周断蒂,皮瓣外形满意,质地柔软,部分皮瓣15个月后恢复保护性感觉.22例患者经过12～36个月骨搬移和部分植骨治疗全部达到骨愈合标准.全部患者得到随访.[结论]应用桥式交叉血管吻合股前外侧皮瓣移植修复严重毁损性肢体巨大缺损创面,可达到最大程度的保肢,提高了保肢的成功率.牵拉成骨技术和桥式“Y”型血管交叉吻合技术的应用,可避免大量取骨,重建健侧胫后动脉的连续性,将供区损害降到最低.带架后早期下床行走,可促进保肢成功后的肢体功能尽早恢复,提高治疗效果.“,”[Objective] To investigate the clinical outcome of bridge flap transplantation combined with Ilizarov technique for treatment of lower limb Gustilo Ⅲ-B/C injury.[Method] Twenty-two cases of limb severe injury left only one main vessel received surgical treatment from 2008 to 2015.Patients aged 10-56 years old (mean,32.6 years),with 14 male,8 female,including left injury in 10 cases and right in 12 cases,traffic injury in 12 cases and machine injury in 10 cases.All cases received flap coverage with anterolateral thigh flap,the “Y” shape vessel in lateral femoral circumflex artery was imbeded in two ends between posterior tibial artery for revascularization.The soft tissue defect was 10cm×20cm～ 18cm×32cm.Bone defect was found in 22 cases,and the tibial defect ranged 18cm to 10cm.All 22 cases received bone repair with Ilizarov traction technique.And bone implantation was carried out in 4 cases.[Result] Flap survived in all 22 cases,and no vessel crisis occurred.Flap pedicle broken in 3 to 4 weeks and the flap appearance was satisfactory.Part of the flap received protective sensation in 15 months.Bone union was achieved in all 22 cases in 12 to 36 months.[Conclusion] Bridge flap transplantation combined with Ilizarov technique can increase the success rate of limb salvage,avoid mass bone implantation and decrease the injury to donor site.Meanwhile,early postoperative excercises can improve the rehabilitation outcomes.