摘要
目的探讨以腓动脉终末穿支为血供的腓肠神经营养血管(肌)皮瓣修复足踝部骨外露并软组织缺损的临床效果。方法对足踝部不同原因所致的骨及软组织缺损患者,设计切取以腓动脉终末穿支远端为蒂的腓肠神经营养血管(肌)皮瓣,以外踝尖上1～3cm处为皮瓣反折点,根据创面的大小设计皮瓣切取范围,切取皮瓣旋转覆盖创面。结果本组共38例,小腿远端25例,足跟部8例,足踝部5例,皮瓣最大面积20cm×10cm,最小3cm×2cm。除1例皮瓣因供区皮肤有挫伤而致皮瓣边沿部分坏死外,其余皮瓣全部成活。经1～5年的随访,治疗效果满意。结论应用远端蒂腓肠神经营养血管皮瓣修复小腿远端及足踝部创伤性骨外露并软组织缺损,伴有死腔者,可一并切取携带腓肠肌肉的皮瓣,有良好的充填死腔作用,皮瓣血供可靠,切取转移方便,操作简单,是修复足踝部皮肤缺损的理想皮瓣。
Objective To investigate the clinical results of repairing the soft tissue defects and bone exposure of ankle and foot with peroneal perforator-based sural neurovascular （neuromusele） faseioeutaneous flap. Method For the patients with soft tissue defects and bone exposure of ankle and foot, peroneal perforator-based sural neurovaseular （neuromuscle） faseioeutaneous flap was designed with reverse upper extramalleolus 1-3era and according to lhe location of skin defect the flap was designed and incised. Result The study contained 38 cases, including 25 cases with the low part of anterior tibial tissue defects,8 cases with heel and foot tissue defects, 5 cases with ankle and foot tissue defects. Their sizes of the flap ranged from 3 cm×2 cm to 20 cm×10 cm. The flaps totally survived in 19 patients, the distal part neerosed in lease because of contund; All the patients were followed up （ranged from 1 year to 5 years）. The texture of the flaps were satisfactory. Conclusion Repairing the soft tissue defects and bone exposure of ankle and foot with peroneal perforator-based sural neurovaseular （neuromuscle）fasciocutaneous flap, for companion respiratory dead space, should incise and take part of gastrocnemius peroneal perforator-based sural neurovascular （neuromuscle） fasciocutaneous flap which has the advantages of reliable blood supply, reverse convenience,simple manipulation. The flap is satisfactory in repairing the soft tissue defects around the heel, the low part of anterior tibial.
出处
《实用医药杂志》
2010年第2期108-109,共2页
Practical Journal of Medicine & Pharmacy
关键词
腓肠神经营养血管皮瓣
腓动脉穿支
移植
软组织损伤
Sural neurofaseiocutaneous flap
Peroneal perforator transplantation
Soft tissue defect
