小腿浅静脉-皮神经营养血管皮瓣修复骨外露缺损创面

Application of the lower limbs cutaneous nerve-superficial vein nutrient vessels flaps to repair the leg bone exposure

目的探讨小隐静脉-腓肠神经、大隐静脉-隐神经营养血管皮瓣修复小腿骨外露缺损创面的方法及疗效。方法对18例各种原因造成的小腿软组织缺损、骨外露分别采用腓肠神经和隐神经营养血管皮瓣进行修复。应用腓肠神经皮瓣12例，其中近端蒂5例，远端蒂7例；隐神经皮瓣5例，其中近端蒂2例，远端蒂3例；两种皮瓣联合应用1例。结果除早期1例皮瓣远端1—2cm宽的不同程度坏死经换药而愈外，余例皮瓣均成活，供、受区形态与功能恢复良好，3个月后X线片显示骨外露处骨质愈合良好。结论此两种皮神经皮瓣血运丰富，抗感染力强，操作简便，是治疗小腿软组织缺损、骨外露、伴有内固定外露、骨感染的一种有效、安全的修复方法。

Objective To explore the applied methods and effects of sural and saphenous neurovascular flaps to repair the leg bone exposure. Methods The 18 cases of the leg bone exposure were repaired with sural and saphenous neurovascular flaps. Sural neurovascular flaps were used in 12 cases （ proximally 5 cases, distally 7 cases）. Saphenous neurovascular flaps were used in 5 cases （ proximally 2 cases, distally 3 cases）. Union of the two flaps was used in 1 case. Results 1 case got flap distal end necrosis about 1 - 2 cm, and recovered after change of dressings. All other flaps survived completely. All 18 cases were outline satisfied, and functioned well. The fractures healed well by X- ray. Conclusions The two cutaneous nerve flaps which have abundance blood supply, high survival rate, operative convenience, are safe and dependable to repair the leg bone exposure.