二种远端蒂皮瓣治疗足踝部软组织缺损

Reconstruction of Foot and Ankle Soft Tissue Defect by Two Distally-Pedicled Flaps

目的 :了解应用腓肠神经营养血管蒂皮瓣及胫后动脉内踝上皮支皮瓣修复足踝部软组织缺损的临床效果。方法 :应用上述方法修复各种原因所致的足踝部软组织缺损共 2 3例。 结果 :2 2例皮瓣全部成活 ,1例皮瓣远端 1～ 2cm皮肤坏死 ,皮瓣面积最大 2 0cm× 10cm ,最小 8cm× 4cm ,随访 6个月～ 3年 ,效果满意。 结论 :应用这两种皮瓣手术简便 ,不损伤小腿主要血管 ,是修复足踝部轻组织缺损的较理想方法。

Objective To evaluate the clinical effect of the repair of foot and ankle soft tissue defect with the reverse fasciocutaneous pedicle flap based on the vascular axis of the sural superficial nerve and the flap of cutaneous branches of posterior fibial artery on the part of superior medial malleolus. Methods From May 1997 to October 2003,there were 23 cases of soft tissue defects on the feet and the ankles due to various trauma repaired with the reverse fasciocutaneous pedicle flop based on the vascular axis of the sural superficial nerve and the flap of cutaneous branches of posterior tibial artery on the part of superior medical malleolus.Results The flaps survived completely in 22 cases and 1 to 3 cm necrosis at distal end of the flap in 1 case,the sizes of the flap ranged from 20 cm×10 cm to 8 cm×4 cm.All of the 23 cases were evaluated as satisfactory after 6 months to 3 years follow-up. Conclusion The operations with these two kinds of flaps can repair most of the soft tissue defects on the foot and ankle and without sacrificing major arteries.1 The flaps are easily made,and the procedures are safe and satisfactory methods.