腓肠神经营养血管远端蒂皮瓣联合腓骨短肌肌瓣治疗跟骨骨髓炎及跟骨缺损

Treatment of calcaneal osteomyelitis and calcaneal defect by distally based sural fasciocutaneous flap combined with peroneus brevis muscle

目的探讨腓肠神经营养血管远端蒂皮瓣联合腓骨短肌肌瓣治疗跟骨骨髓炎及跟骨缺损的临床疗效。方法回顾分析2010年5月至2015年3月北京积水潭医院烧伤科15例跟骨骨折导致跟骨骨髓炎患者的临床资料。其中男11例,女4例;年龄15～68岁,平均39.7岁。15例患者彻底清创后均有跟骨较大较深缺损,且有皮肤和软组织缺损,应用腓骨短肌肌瓣填充跟骨清创后形成的空腔,用腓肠神经营养血管远端蒂皮瓣修复皮肤和软组织缺损。结果 15例患者皮瓣完全成活,切口均Ⅰ期愈合,随访3～24个月,骨髓炎未见复发。结论腓肠神经营养血管远端蒂皮瓣联合腓骨短肌肌瓣治疗跟骨骨髓炎所致较大跟骨缺损安全有效,易于操作。

Objective To investigate clinical significance of distally based sural fasciocutaneous flap com- bined with peroneus brevis muscle for treatment of calcaneal osteomyelitis and calcaneal defects. Methods From May 2010 to March 2015, after radical debridement of all nonviable and poorly vascularized tissue, 15 cases with calcaneal osteomyelitis and calcaneal defects following calcaneal fracture were treated with distally based sural fas-ciocutaneous flap combined with peroneus brevis muscle. They were including 11 males and 4 females, and aged 39.7（15-68） years. Results All fasciocutaneous flaps survived completely and all wounds healed uneventfully. Fifteen cases were followed up for 3 to 24 months with no recurrence of osteomyelitis. Conclusion It is effective and feasible to use distally based sural fasciocutaneous flap combined with peroneus brevis muscle to repair calca-neal osteomyelitis and calcaneal defects.