带血管蒂第二跖骨底骨瓣移位修复外踝骨缺损

TRANSFERRING OF THE PEDICLED SECOND METATARSAL BASE FOR REPAIRING BONE DEFECT OF LATERAL MALLEOLUS

目的 探讨带血供第二跖骨底骨瓣移位修复外踝骨缺损的方法及临床效果。方法 在 30侧成人下肢标本解剖观测第二跖骨底形态、结构和血供来源 ,设计以足背血管为蒂的第二跖骨底骨瓣移位修复外踝骨缺损的术式。临床应用 6例 ,其中外伤性骨缺损 5例 ,骨肿瘤 1例合并皮肤缺损。结果 采用带血管蒂第二跖骨底骨瓣修复 5例 ,另加足背皮瓣修复 1例。术后全部获 3～ 11个月随访 ,骨瓣愈合时间为 3～ 4个月 ,步态正常 4例 ,轻度跛行 2例。结论 第二跖骨底骨瓣血管解剖位置恒定 ,移位灵活 ,手术操作简便 ,对供区影响小 ,再造的外踝外形近似正常 ,是修复外踝骨缺损的一种有效新术式。

Objective To study the method and effect of transferring the pedicled second metatarsal base for repairing bone defect of lateral malleolus. Methods Thirty lower limb specimens were anatomized to observe the morphology, structure and blood supply of the second metatarsal bone . Then transferring of the pedicled second metatarsal base was designed and used in 6 patients clinically. All cases were male, aged from 24 to 48 years old, and the area of bone defect was 3-4 cm. Results Followed up for 3-11 months, all patients healed primarily both in donor and recipient sites. There were excellent results in 4 cases and good results in 2 cases . The morphology and function of the malleoli were satisfactory. Conclusion Transferring of the pedicled second metatarsal base for repairing bone defect of lateral malleolus is an effective and reliable operative method.