胫后动脉内踝上穿支筋膜瓣逆行翻转180°修复跟踝创面的疗效观察

Clinical efficacy Repairing heel and malleolus wounds with turn-over 180 degreesby medial supramalleolar perforator fascial flap of posterior tibial artery

目的 探讨胫后动脉内踝上穿支筋膜瓣逆行翻转180°修复跟踝创面临床效果。方法 自2010年2月—2015年4月,应用胫后动脉内踝上穿支筋膜瓣逆行翻转180°修复跟踝创面13例,创面均合并跟腱或骨外露,供区原位缝合,蒂部反折处及筋膜瓣表面游离植皮修复。结果 术后13例筋膜瓣成活无虞,供区切口及受区移植皮片均愈合良好。随访6-15个月,患者跟踝部外形无明显臃肿,可正常穿鞋行走,小腿供瓣区仅遗留一条线状瘢痕。结论 胫后动脉内踝上穿支筋膜瓣具有不损伤主干动脉,组织瓣成活可靠,供区美观,受区外形佳,对穿鞋影响小等优点,是修复跟踝创面有效的治疗方法之一。

Objective To investigate the clinical efficiency of repairing heel and malleolus wounds with turn -over 180 degrees by me-dial supramalleolar perforator fascial flap of posterior tibial artery.Methods Application of medial supramalleolar perforator fascial flap of posterior tibial artery 180 degrees rotation to cover defects of heel and malleolus in 13 patients from February,2010 to April 2015. Defects were assiociated with exposed bone or tendon,donor sites were directly sutured.The surface of roots and fascia flap were re-paired by pedicled skin graft.Results The fascial flap survived totally in 13 cases,both donor and recipient sites were closed primari-ly.After followed up of 6 -15 months,patients with ankle shape no obvious bloated,and all patients re -covered walking and shoe wearing function.Only a 1inear scar was left at the calf donor site.Conclusions Fascial flap of medial supramalleolar perforator fascial flap of posterior tibial artery have the advantage of little damage to the main blood vessels,high reliability in flap survival,both donor and recipient have beautiful appearance,little influence for walking function,it is a effective method to repair the heel and malleolus wounds.