摘要
目的探讨修薄的股前外侧肌瓣联合皮片移植修复足部非负重区软组织缺损创面的疗效。方法2009年1月至2017年1月，采用修薄的股前外侧肌瓣联合皮片移植修复足部非负重区软组织缺损共25例；创面缺损部位：足内侧5例，足背10例，足外侧7例，足趾端3例；创面缺损面积：8.0 cm×6.0 cm^18.0 cm×10.0 cm；肌瓣大小：4.0 cm×3.0 cm×0.3 cm^10.0 cm×8.0 cm×1.5 cm，所有病例均在骨折固定、创面无明显感染下进行；患者均于术后4周在支具保护下行早期康复训练,1年后随访根据Maryland足功能评定标准评估伤肢功能。结果游离肌瓣及植皮全部成活，创面愈合时间12~24 d,平均17.1 d；术后随访12~24个月，平均16.2个月；术后患者均可正常穿鞋，恢复正常生活与工作；根据Maryland足功能评定标准，优22例，良3例。结论修薄的股前外侧肌瓣联合皮片移植修复足部非负重区软组织缺损，大腿组织瓣供区损伤小，肌瓣易切取，且可避免足踝部常规游离皮瓣术后外观的臃肿。
ObjectiveTo investigate the clinical effect of reconstruction of soft tissue defect in non-weight-bearing area of the foot with trimmed free anterolateral thigh muscle flap combined with skin grafting.
MethodsFrom January, 2009 to January, 2017, 25 patients with soft tissue defect in foot and ankle were treated with transplantation of the trimmed free anterolateral thigh muscle flap combined with skin grafting. Of the 25 cases, there were 5 cases located in medial foot, 10 cases in dorsum of foot, 7 cases in external of foot and 3 cases in the toe. The areas of wounds were 8.0 cm×6.0 cm to 18.0 cm×10.0 cm. The anterolateral thigh muscle flap was from 4.0 cm×3.0 cm×0.3 cm to 10.0 cm×8.0 cm×1.5 cm. All the cases were operated in fracture fixation and wound without obvious infection. Early rehabilitative exercise under the protection of orthosis were done after 4 weeks of the operation and to assess. The injuried limb function were assessed in 1 year postoperatively according to Marylands scale.
ResultsAll cases were followed-up for 12 to 24 months （average, 16.2 months） . All the muscle flaps and skin survived. The healing time were 12 to 24 days, averaged of 17.1 days. Patients could wear shoes normally and resume normal life and work. The appearance and walking function were satisfying and no further debulking procedures were needed. The surgery function were assessed according to Marylands scale, and the results was 22 cases for excellent, and 3 cases for good.
ConclusionTtrimmed free anterolateral thigh muscle flap combined with skin grafting is a good option for the repair of foot and ankle defect at non-weight-bearing area, and it has the advantages such as the doner site is small invasive, the muscle flap is easy to be harvested, and can avoid debulking surgery to wear shoes normally.
作者
胡锐
任义军
严立
陈熹
程可可
李善庆
廖苏平
韩琼
Hu Rui;Ren Yijun;Yan Li;Chen Xi;Cheng Keke;Li Shanqing;Liao Suping;Han Qiong(Department of Orthopedics,The Fourth Hospital of Wuhan,Puai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,China)
出处
《中华显微外科杂志》
CSCD
北大核心
2018年第5期433-436,共4页
Chinese Journal of Microsurgery
基金
湖北省卫计委一般项目课题（WJ2015MB155）
关键词
股前外侧肌瓣
足
移植
软组织缺损
显微外科技术
Anterolateral thigh muscle flap
Foot
Transplantation
Soft tissue defect
Microsurgical technique
