带血管蒂附骨瓣移位术的临床应用

CLINICAL APPLICATION OF TRANSPOSITION OFTHE VASCULARIZED TARSAL BONE FLAPS

根据跗骨血供的解剖学研究，发现足背动脉的分支内踝前动脉、跑内侧动脉及跗外侧动脉有恒定的骨膜支分布于第一楔骨及骰骨的背侧面。以上述血管为蒂可以切取第一楔骨及骰骨骨瓣，用于修复足踝部骨析、骨不连及骨缺损。１９９１年以来，施行带跗外侧血管蒂骰骨瓣移位术３例，带内踝前或跗内侧血管蒂第一楔骨瓣移位术３例。经随访各例骨连接良好，无并发症。认为对于足踝部某些骨折、不连接及小量骨缺损，本法是一种安全、简便、有效的手术方法。

AbstractAn anatomic study has demonstrated that there isa constant blood supply from periosteous vessles to thedorsal part of the cuboid bone and the medialcuneiform bone, which arise from the lateral or medialtarsal artery and the medial anterior rnelleolar arteryissued from dorsal artery of foot. A cuboid bone flap ormedial cuneiform bone flao can be raised for the treat-ment of fracture. non union or defect of the bonesnearby. Since 1991. 3 cuboid bone flaps pedicled withthe lateral tarsal artery and 2 medial cuneiform boneflaps based on medial anterior melleolar artery or me-dial tarsal artery have been used with a satisfactory re-sults. It is believed that the transposition of vascu-larised tarsalbone flaps are simple and useful in footsurgery.