腓动脉骨皮穿支蒂小腿外侧皮瓣逆行转位修复外踝部软组织缺损

The reverse extended lateral crural flap pedicle with peroneal artery bonecutaneous perforator for soft tissue defects of the lateral malleolus

目的 介绍腓动脉骨皮穿支蒂小腿外侧皮瓣逆行转位修复外踝部软组织缺损的临床体会。方法对各种因素导致的外踝周围软组织缺损，采用以腓动脉在小腿中下1／3交界由腓动脉滋养动脉发出的皮支，即骨皮穿支为蒂的小腿外侧逆行岛状皮瓣修复，切取时可将腓肠神经外侧束包含于皮瓣内。结果本组12例．术后10例皮瓣均顺利成活，2例皮瓣术后远蒂端出现静脉回流受阻征象，经拆除蒂部缝线后完全成活，所有病例经3～6个月随访，皮瓣外形满意，供受区伤口愈合佳。结论采用腓动脉骨皮穿支蒂小腿外侧皮瓣逆行转位是修复外踝周围软组织缺损的好方法。

Objective To investigate the operative technique and clinical results of repairing soft tissue defects of the Lateral malleolus with reverse extended lateral crural flap pedicle with peroneal artery bonecutaneou perforator. Methods 12 Patients with soft tissue defect of the Lateral malleolus were treated by reverse extended lateral crural flap pedicle with bonecutaneou perforator, which was located in the lower 1/3 of the leg from peroneal artery. The lateral cord of sural nerve was included with the flap. Results All 10 cases survived after operation. Partial inadequate venous return and distal superficial necrosis occured in only 2 cases. Which also got secondary healing by removing the pedicle suture dressing. The donor sites reached primary healing completely. After following up for 3-6 months, the appearance and function of the flaps were all satisfactory. And noinfluence to ambulation was found. Conclusion The lateral crural reverse island skin flap with perforating branches of sural artery is a good method for extramalleolus soft tissue defect.