足内侧皮瓣逆行移植术

Retrograde transplantation of the medial pedis flap

目的 为足前部软组织缺损提供修复方法。 方法 (1)在 5 0侧足标本上解剖观察足内侧皮瓣的血供来源、动脉分支及终支远侧吻合情况 ,皮瓣逆行供血及回流的途径 ;(2 )临床设计应用足内侧皮瓣逆行移植修复前足软组织缺损 6例 (趾截趾残端 2例、趾侧方 1例、前足底 2例、足背远端1例 )。其中以足背动脉及其内侧分支为蒂 4例 ,足底内侧血管蒂 1例 ,第一跖骨内侧动脉终支 1例。皮瓣面积 :4.5 cm× 4.0 cm～ 7.0 cm× 5 .0 cm。 结果 (1)发现足内侧皮瓣有足背动脉内侧分支和足底内侧动脉浅支及深支内侧支多个供血来源。足背动脉与足底内侧动脉经足底深支相互吻合 ;跖背动脉与跖底动脉、足背动脉弓与足底弓之间有丰富的穿支相互吻合 ,且动脉与吻合支均有静脉伴行 ;(2 )临床应用 6例皮瓣全部成活 ,修复效果满意 ,无并发症发生。 结论 足内侧皮瓣逆行移植修复足前部软组织缺损 ,具有手术简便、安全、效果好、并发症少等优点。

Objiective To supply a method for repairing soft tissue defect of forefoot Methods (1)A detailed anatomical study in 50 cadaveric feet were performed for observing the arterial branches and their anastomoses, the routes of blood supplies and refluxes of the medial pedis flap while retrograde transferring (2) The flap was used in 6 patients with soft tissue defect of forefoot Results (1) The blood supply of the medial pedis flap comes from medial branches of dorsal pedal artery and medial plantar pedal artery Dorsal pedal artery and medial plantar pedal artery anastomose via the deep branch of dorsal pedal artery These arteries and anastomosis branches all have accompanying vein (2) All flaps survive completely with satisfactory results Conclusions Retrograde transferring of the medial pedis flap for repairing the soft tissue defect of forefoot is an easy and reliable method with fewer complications