改良的游离腓骨瓣制备方法

A Modified Technique for Harvesting Fibula Free Flap

目的 :介绍一种改良的游离腓骨瓣制备方法。方法 :在暴露小腿外侧肌间隙后 ,首先完成整个腓骨血管蒂的解剖 ,随后再分离腓骨外侧和前方的肌肉附丽 ,待完成腓骨上下端的截骨后 ,将腓骨向后旋转 ,暴露小腿骨间膜并于直视下切开 ,最后将腓骨向前旋转 ,切断腓动、静脉远端及胫后肌 ,完成腓骨瓣的制备。结果 :采用此方法完成 2 0例游离腓骨瓣制备 ,平均手术时间明显少于常规的方法 ,单纯腓骨瓣需 40～ 5 0min ,腓骨骨肌皮瓣需 5 0～ 70min。结论 :改良的游离腓骨瓣制备方法克服了常规方法的缺陷 ,更为快捷、简便、安全、可靠 。

Objective:To introduce a modified technique for harvesting fibula free flap.Methods:Flap elevation was begun with the dissection of vascular pedicle.After peroneal artery and veins were isolated to their origin from tibioperoneal trunk,they were subsequently dissected distally along the fibula to its distal osteotomy site.After the anterior compartment muscles were removed from the bone,the interosseous membrane was not divided until the osteotomies were finished and the bone was rotated posterior for better exposure of the membrane.Results:This echnique was used for harvesting 20 fibula free flaps.All the operations were successfully finished,and the average operating time was significantly shortened compared with the conventional methods.Conclusion:The modified technique has several advantages over the conventional method.It should be advocated for harvesting fibula free flap.