腓肠肌内侧头推进肌皮瓣修复小腿软组织缺损

MYOCUTANEOUS ADVANCEMENT FLAPS OF GASTROCNEMIUS(MEDIAL HALF)TO REPAIR LEG DEFECTS

目的：用腓肠肌内侧头肌皮瓣以推进法修复小腿软组织缺损。方法：用改进腓肠肌带血管蒂以及双蒂肌皮瓣加屈膝推进法修复胫骨外裸及钢板外露8例、胫骨慢性骨髓炎8例、软组织全层缺损6例和贴骨疤痕及溃疡3例。结果：25例中除2例超限肌皮瓣远端表皮坏死外，全部肌皮瓣一次性消灭创面，成活率100．0％；8例慢性骨髓炎患者平均随访5年未见复发。结论：增加肌皮瓣后缘宽度及减少膝关节角度均可使肌皮瓣向小腿远端延伸，可最大限度地修复远端组织缺损。

Objective: To introduce myocutaneous advancement flaps of gastrocnemius (medial half)for repairing leg defects. Mathods: Using myocutaneous advancement flaps of gastrocnemius or bipedicled flaps with or without flexion of knee for 8 cases of tibia and steel plate exposure, 8 cases of chronic osteomyelitis of tibia, 6 cases of solf tissue defects and 3 cases of both cicatrix and ulcer overlying a bone surface. Results: Except the epidermic necrosis on the distal apex of the flap in 2 cases due to undue tension, all of the myocutaneous flaps survived with primary heeling. The survival rale was 100. 0%. There was no recurrence in these 8 patients with chronic osteomyelitis in the period of 5-year follow-up. Conclusion:By enlarging the width of the flap and flexing the knee in optimum position the flap can be extended more distad to repair leg defects.