腓肠神经营养血管皮瓣的临床应用

Clinical application of skin flap supplied by sural nerve nutrition blood vessel

目的探讨腓肠神经营养血管皮瓣的临床应用特点。方法用腓肠神经营养血管皮瓣对９例足跟、踝、跟腱和胫前区软组织缺损的病例进行修复；同时观察和测量腓肠神经营养血管的发出部位、腓肠神经的支数和行走特点。结果９例中８例皮瓣生长良好，１例部分坏死８例。成人腓肠神经营养血管的发出部位在外踝上６．５～７ｃｍ处，１例小儿的发出部位在外踝上５ｃｍ。腓肠神经有６例是以内侧支为主，３例是内侧支和外侧支基本等粗，而且靠得较近。腓肠神经及营养血管在小腿中部会穿深筋膜进入腓肠肌。以顺行分离皮瓣较可靠，可避免脱套。结论腓肠神经营养血管皮瓣切取简便，不需吻合血管，是修复足跟、内外踝。

Objective To investigate the characteristics of clinical application of skin flap supplied by sural nerve nutrition blood vessel Methods\ The flaps were used in 9 cases to repair the soft tissue defect in heel,mallelous, anterior tibial and achilles tendon Meanwhile the clinical characteristics of these flaps were surveyed Results Eight cases of 9 cases survived satisfectory One case presented partially necrosis The site of the penetrated branch vessels which supply the sural superficial nerve comes out, 6 5～7 cm above the lateral malleolus Sural nerve with its nutrition blood vessels goes through into the gastrocnemis muscles through profound fascia in about meddle part of leg So, it will be safer to dissect the flap along the sural nerve from distal to proximity to preventing from degloving Conclusions The sural nerve nutrition blood vessel flap is easy to elevate and safety, which is an ideal flap for repairing the soft tissue defect around the heel, malleolus,achilles tendon and the low 1/3 part of anterior tibial