胫前联合踝前皮瓣的临床应用

Clinical application of the combined the anterior malleolus flap and anterior tibia flap

目的探讨胫前联合踝前皮瓣临床应用效果。方法根据胫前动脉中下段的穿支应用解剖，设计胫前联合踝前皮瓣，修复前足皮肤坏死的创面5例，切除皮瓣面积17cm×10cm-10cm×5cm，切取面积上界至胫骨粗隆，下界至内外踝连线，两侧至小腿侧中线。结果术后皮瓣全部成活，供区植皮愈合良好，随访2～24个月，成活的皮瓣质地良好，没有发生磨损破溃现象，临床治疗效果满意。结论胫前联合踝前皮瓣扩大了皮瓣的切取面积并有良好的血运，可以用来修复前足大面积皮肤缺损。

Objective To investigate the clinical application of the combined the anterior malleolus flap and anterior tibia flap. Methods Based on the dissection of the perforating branches of anterior tibial artery on the middle and inferior section, the combined the anterior malleolus flap and anterior tibia flap was designed to repair the necrotic skin of anterior foot for 5 patients. The sizes of the flaps ranged from 17 cm × 10 cm-10 cm× 5 cm. And the area of the flap was from tibial tuberosity（upper bound） to the line between internal malleolus and external malleolus （lower bound）, and from the median line of one side of leg to the other side. Results Postoperatively,all flaps survived, and the primary healing of transplanted skin in donor site was achieved.The texture of flaps were excellent, the phenomenon of abrasion did not happen, and the clinical therapeutic efficacy was satisfactory after a follow up of 2-24 months. Conclusion It＇s a good method that combined the anterior malleolus flap and anterior tibia flap, which not only could enlarge the area of the flap but also has reliable blood supply, in repair of large size skin defect of anterior foot.