小腿内侧皮支皮瓣修复足踝部软组织缺损7例报告

Repair of soft tissue defects on the foot and ankle with flaps of cutaneous branches of the low medial leg

目的探讨小腿内侧皮支皮瓣修复足踝部软组织缺损的临床效果。方法2003年3月～2005年10月，我院应用小腿内侧皮支皮瓣转移修复各种原因所致的足踝部软组织缺损7例。以胫骨内侧缘为纵轴，在比目鱼肌与趾长屈肌间隙，寻找胫后动脉皮支，根据皮支位置及长度，确定切取皮瓣的范围和位置，将皮支皮瓣转移至皮肤软组织缺损区，供区游离植皮。结果手术时间3～5h，平均4．2h。7例术后皮瓣全部成活，随访5～18个月，平均10个月，基本保持足部外形和功能，可满足日常生活自理的需要。结论小腿内侧皮支皮瓣不牺牲小腿主要血管，修复足踝部软组织缺损，手术简单安全，是一种比较理想的方法。

Objective To investigate clinical effects of cutaneous branch flaps of the low medial leg for the repair of soft tissue defects on the foot and ankle. Methods A flap with pedical of cutaneous branches of the low medial leg was used for the repair of 7 cases of skin and soft tissue defects on the feet and ankle from March 2003 to October 2005. The cutaneous branches of the posterior tibial artery were identified along the medial border of the tibia and between the soleus muscle and the flexor digitorum longus muscle. The flap was mobilized according to the site and length of the cutaneous branches, and was transferred to soft tissue defects for skin grafting. Results The operating time was 3～5 hours （mean, 4.2 hours）. The flaps survived completely in all the 7 cases. Follow-up checkups were carried out for 5～18 months （mean, 10 months）, The appearance and functions of the foot were satisfactory and met the requirements for daily activities. Conclusions The procedure can effectively repair soft tissue defects on the foot and ankle and does not sacrifice the major arteries. This flap is easy to be prepared.