足背皮神经营养血管皮瓣的临床应用与解剖学研究

Dorsal pedal neurocutaneous flap： clinical application and anatomy

目的评估足背皮神经营养血管皮瓣的疗效。方法成人下肢标本32侧，解剖观测足背皮神经及其营养血管分布，设计皮瓣。临床应用逆行足背皮神经营养血管皮瓣修复足背软组织缺损30例。结果可单独设计足背内侧、中间和外侧皮神经的顺行或逆行皮神经营养血管皮瓣，腓深神经终末支皮神经营养血管皮瓣可以和足背内侧皮神经营养血管皮瓣联合使用。临床皮瓣的切取面积为（3．5～5．5）cm×（2．0～9．0）cm。27例愈合顺利，3例经按摩后完全存活。平均随访2．3年。外观满意，穿鞋无碍。结论逆行足背皮神经营养血管皮瓣修复足背中、小面积软组织缺损疗较满意，简便有效。

Objective To evaluate the clinical effects of the dorsal pedal neurocutaneous flap.Methods The observation and measurement of the dorsal pedal cutaneous nerves and their nutrient arteries were made on 32 adult specimens of lower extremity.The neurocutaneous flaps were designed accordingly.Thirty cases with dorsal foot defects were reconstructed with these flaps.Results The medial, intermediate and lateral neurocutaneous flap can be applied independently while the peroneal deep neurocutaneous flap could be harvested with the combination of the medial neurocutaneous nerve.The flaps size chnically were（3.5-5.5）cm×（2.0-9.0）cm.The flaps of 27 cases healed uneventfuUy while 3 cases survived entirely with massage.The mean following-up was 2.3 years. The contour of the flaps were satisfactory when the patients had no obvious difficulty in putting on shoes. Conclusion The method of transfer of reverse dorsal pedal neurocutaneous flap was effective and convenient in repair for medium size of defects in dorsal foot.