逆行腓肠神经营养血管皮瓣在修复足踝部软组织缺损中的应用

Clinical applications of the antidromic neurocutaneous flap supplied by sural nerve nutrition blood vessels in repairing the foot and ankle soft tissue defect

目的:探讨和评估逆行腓肠神经营养血管皮瓣对修复踝足部软组织缺损的疗效。方法:应用逆行腓肠神经营养血管皮瓣来修复踝足部软组织缺损26例,其中16例逆行皮瓣采用吻合皮神经促进感觉恢复。结果:除1例皮瓣远端部分坏死,其余皮瓣均成活良好。经9～18个月随访,疗效满意,足跟部的两点辨别觉达1.0～1.2cm。结论:逆行腓肠神经营养血管皮瓣是修复足踝部软组织缺损的理想皮瓣,其具有切取方便,血供可靠,成活率高的优点;缝合皮神经利于受区保护性感觉的恢复。

Objective：To investigate the clinical results of the antidromic sural nerve nutrition blood vessel flap in repairing the foot and ankle soft tissue defect. Methods：The antidromie neurocutaneous flap of pedicle with sural nerve and its nutrient vessels was applied to repair soft tissue defects in foot 7 cm and the average 11-12 cm and ankle in 26 cases,the circumvolving angle was 100 repaired in 16 cases to resuming protective sense. Results：Except for one flap with partial necrosis, all flaps survived completely. The appearance and functional results were satisfactory as revealed by follow-up for 9 to 12 months. The tow point differentiating distance was about i. 0- 1.2 cm. Conclusion： Sural nerve nutrition blood vessel flap has more reliable blood supply and does not need to damage important vessels and nerves. It is simple and ease to be done,and provides an effective method for repairing the defect of soft tissue on the foot and ankle. It is a good method for repairing the skin nerve to resume protective sense of foot.