“网球拍”状足底内侧逆行皮瓣修复前侧足底缺损的疗效

Efficacy of ＂tennis racket＂-Iike flap with retrograde medial plantar on repairment of frontal plantar tissue defects

目的探讨“网球拍”状足底内侧逆行皮瓣修复前侧足底缺损的疗效。方法2011年6月至2016年6月，采用“网球拍”状足底内侧逆行皮瓣修复10例前足底缺损，缺损合并有骨、肌腱外露，皮瓣面积3．5cm×2．0cm至8．0cm×4．0cm，供区均植皮修复。结果10例皮瓣完全成活，供区均一期愈合，外观良好、瘢痕小。10例均随访6～24个月，平均12个月。术后足底创面外观恢复良好，皮瓣质地外形满意。足部功能按下肢肢体功能障碍标准评定：优7例，良2例，可1例，优良率90％。结论“网球拍”状足底内侧逆行皮瓣解剖变异少，血供丰富，感觉恢复快，供区凹陷小，瘢痕挛缩轻，费用少，一次性完成手术，是修复前侧足底缺损较为理想的方式。

Objective To explore the clinical experience and surgical method of the repairment of frontal plantar tissue defects by using ＂tennis racket＂ -like flap with the medial plantar retrograde, and to study the reliability in the clinical application of the medial plantar retrograde flap. Methods From June 2011 to June 2016, ＂tennis racket＂-like flap with the medial plantar retrograde was used to repair the frontal plantar tissue defects in 10 cases. The cutting range of flap was from 3.5 cm×2.0 cm to 8.0 cm × 4.0 cm in size; in all patients the donor area was covered by skin grafts. Results All flaps survived and wounds healed by first intention. In 10 patients the donor sites healed primarily with a straight scar, and the appearance and texture of the flaps were satisfactory. All patients were followed up from 6 to 24 months （mean 12 months）. According to the Chinese foot function evaluation standard trial evaluation, the outcomes were excellent in 9 cases, good in 7 cases, and medium in 2 cases. Conclusions ＂Tennis racket＂dike flap with the medial plantar retrograde is less anatomic variation with reliable blood supply, and sensory recovery is quick; the donor site is a small crater and cicatrial contractures are light; the cost is low. All patients are treated on one session and therefore it is an ideal method for the repairment of frontal plantar tissue defects.