低位隐神经营养血管远端蒂皮瓣修复足背软组织缺损

Repair of soft tissue defect in forefoot with the distally based saphenous neurocutaneous flap

目的报道低位隐神经营养血管远端蒂皮瓣修复足背组织缺损临床效果。方法在应用解剖研究的基础上,2010年1月以来,临床采用低位隐神经营养血管远端蒂皮瓣治疗踝足背外伤患者11例。结果修复足背、跟腱区创面计11例,皮瓣完全成活,皮瓣面积最大11.0 cm×6.0 cm,最小7.0 cm×4.0 cm.。经6～10个月随访,皮瓣柔软,可塑性好,色泽与受区接近,部分病例感觉有不同程度恢复。结论小腿内侧远端的血供具有多源性、纵向性和营养血管同源性的解剖学特点,是构成低位远端蒂皮瓣的解剖学基础,可以设计以胫后动脉肌间隙支低位隐神经营养血管远端蒂皮瓣,适宜踝足部及其远侧的组织缺损修复。

Objective To explore clinical effects of the distally based neurocutaneous saphenous island flap on the repairing of soft tissue defects in the dorsum of foot.Methods According to the size and site of the defect and the rotation point,the flap was designed,based on the arterial axis associated with the saphenous nerve and the greater saphenous vein.11 patients received surgical flap transplantation.Results For all of cases,neurocutaneous saphenous island flaps survived well.The area of lived flaps ranged from 7.0cm×4.0cm to 11.0 cm×6.0 cm.The patients were followed up for 6 to 10 months.All the flaps survived completely,with the satisfied appearance and functions.Conclusions The blood supply of medial-distal leg is abundant,which is the anatomic basis for designing and using of neurocutaneous flap,furthermore,the distally based saphenous neurocutaneous flap is useful for repairing of soft tissue defect in forefoot.