第一跖底动脉足内侧穿支皮瓣修复第一跖趾关节附近软组织缺损

Clinical application of the medial perforator flap of the first plantar artery to repair soft tissue defect near the first metatarsophalangeal joint

目的探讨应用第1跖底动脉足内侧穿支皮瓣转移修复第1跖趾关节附近软组织缺损的临床效果。方法2016年1月至2018年4月,山东省警官总医院骨科收治第1跖趾关节附近软组织缺损患者10例,男6例,女4例,年龄22~61岁,平均40岁。均采用第1跖底动脉足内侧穿支皮瓣修复,皮瓣供区以刃厚皮片修复。观察术后修复效果。结果本组10例,皮瓣及植皮全部成活,术后均获12~22个月随访,皮瓣无臃肿、破溃,患足负重行走正常。结论第1跖底动脉足内侧穿支皮瓣穿支恒定,切取简单,皮肤质地与周围相近,皮瓣切取后对足部血供无影响,是修复第1跖趾关节附近软组织缺损的理想皮瓣。

Objective To investigate the clinical effect of the medial perforator flap of the first plantar artery for repairing the soft tissue defect near the first metatarsophalangeal joint.Methods From January 2016 to April 2018,10 patients of soft tissue defect near the first metatarsophalangeal joint were treated in the Department of Orthopedics,Shandong Police General Hospital,including 6 males and 4 females,aged 22-61 years old,with an average age of 40 years.The defects of the feet were recovered by the medial perforator flap of the first plantar artery,and the flap donor defects were covered by split-thickness skin grafts.Results All flaps and skin grafts of the patients were survived.All patients were followed up for 12-22 months postoperationly/after operation.The flaps were not swollen or ruptured,and the patients walked normally with full weight-bearing.Conclusions The perforator artery of this flap is consistant,the harvesting of the flap is simple,and the texture of skin is similarwith surrounding tissue,there is no deficit to the flood supply of the foot after harvesting the flap.So,it is an ideal choice for repairing the defect of the soft tissue near the first metatarsophalangeal joint.