摘要
目的探讨小腿内侧一蒂两瓣桥式带蒂转移修复对侧小腿软组织缺损的临床效果。方法对2012年1月至2018年1月收治的12例对侧小腿软组织缺损患者,均以胫后动脉为蒂小腿内侧筋膜瓣联合内侧半比目鱼肌瓣桥式带蒂转移术治疗。其中男性9例、女性3例,年龄18~53岁,软组织缺损范围为12 cm×8 cm^18 cm×9 cm。筋膜瓣、肌瓣和血管蒂表面行一期中厚网状游离植皮,供区直接缝合。小腿内侧一蒂两瓣移植成活后,再行断蒂术。结果术后所有患者的筋膜瓣和肌瓣全部成活,术后均未发生血管危象。1例发生肌瓣远端小块植皮坏死,经2周换药处理后愈合。术后随访2.5~4.5年(平均3.8年),受区和供区外形较好,疗效较满意。结论小腿内侧一蒂两瓣桥式带蒂转移修复方法适用于治疗小腿仅有1条主要血管的软组织缺损的治疗,可减轻对供区的损伤。
Objective To evaluate the clinical efficacy of the bridge pedicled transplantation of medial leg fascial flap combined with medial hemisoleus muscle flap for contralateral leg soft tissue defect.Methods Between January of 2012 and January of 2018,12 patients with soft tissue defect of the leg were treated with bridge pedicled transplantation of contralateral medial leg fascial flap combined with medial hemisoleus muscle flap by posterior tibial artery.There were 9 males and 3 female,aged from 19 to 53 years(mean,35 years).The size of the soft-tissue defects ranged from 12 cm×8 cm to 18 cm×9 cm.The immediate coverage of the fascial and muscle flaps and vessel pedicle were repaired by a meshed split-thickness skin graft.The donor site was closed directly.After the transplantation of the one pedicle and two flaps survived,vascular pedicle was cut off.Results All the fascial and muscle flaps survived completely.No clinical vascular deficiency was found on the fascial and muscle flaps postoperatively.One case developed distal muscle flap small skin graft necrosis,and spontaneous healed after 2 weeks of dressing change.Follow-up period ranged from 2.5 to 4.5 years(mean 3.8 years).A good contour was confirmed both at the recipient and donor sites.Satisfactory clinical results were obtained in this series.Conclusion This method is suitable for the treatment of soft tissue defects of the leg with only one major blood vessel,which reduces the damage to the donor site.
作者
张功林
冯致举
师富贵
王行高
何如祥
胡军
孙萍
岳孝太
赵文学
王伟世
Zhang Gonglin;Feng Zhiju;Shi Fugui;Wang Xinggao;He Ruxiang;Hu Jun;Sun Ping;Yue Xiaogtai;Zhao Wenxue;Wang Weishi(Department of Orthopedic Surgery,Lanzhou Hand and Foot Surgery Hospital,Lanzhou 730050,China)
出处
《中华全科医师杂志》
2020年第7期624-627,共4页
Chinese Journal of General Practitioners
基金
兰州市科学技术局项目(2018-4-60)。
关键词
胫骨骨折
小腿
骨折
外科皮瓣
修复外科手术
Tibial fractures
Leg
Fractures
bone
Surgical flap
Reconstructive surgical procedures
