胫后动脉内踝上穿支蒂隐神经营养血管逆行岛状皮瓣修复足背及踝部软组织缺损

On the medial malleolus perforators saphenous nerve nutrition blood vessels retrograde island flap of pedicled with posterior tibial artery to repair the soft tissue defect in the back foot and ankle

目的：总结胫后动脉内踝上穿支蒂隐神经营养血管逆行岛状皮瓣修复足背及足踝部软组织缺损的疗效。方法2012年4月-2015年4月，应用胫后动脉内踝上穿支蒂隐神经营养血管逆行岛状皮瓣修复足背及足踝部软组织缺损7例。皮瓣面积：5.0 cm×6.0 cm^10.0 cm×18.0 cm。结果6例皮瓣完全成活，1例皮瓣远端边缘浅表性坏死，经换药后愈合。术后随访2~18个月，平均10个月。皮瓣质地、血运较好，颜色正常，感觉有一定恢复，外观与功能均满意。结论胫后动脉内踝上穿支蒂隐神经营养血管皮瓣，不损伤胫后动脉主干，血运可靠，是修复足背及足踝部皮肤软组织缺损的较好方法。

Objective To summarize the curative effect of medial malleolus perforator pedicled with saphenous nerve nutritional vessel retrograde island flap of posterior tibial artery to repair dorsum of foot and ankle soft tissue defect. Methods From April 2012 to April 2015, the application of medial malleolus perforator pedicled with saphenous nerve nutritional vessel retrograde island flap of posterior tibial artery to repair dorsum of foot and ankle soft tissue defect in 7 cases. The flap area was 5.0 cm×6.0 cm^10.0 cm × 18.0 cm. Results 6 flaps survived completely, 1 case of distal flap edge of superficial necrosis healed, through dressing the wound. Followed up for 2~18 months, on average of 10 months. The texture of the flap and blood supply were good, color was normal, feeling was certain recovery, appearance and function were satisfactory. Conclusion The medial malleolus perforator pedicled with saphenous nerve nutritional vessels flap of posterior tibial artery, is a good method for the repair of skin defect in the dorsum of the foot and ankle, no damage to the posterior tibial artery, reliable blood supply.