足外侧血管链在防治跟骨外侧“L”型切口皮肤坏死中的临床应用

Clinical application of lateral vascular chain of foot in the prevention of cutaneous necrosis in lateral L-shaped incision of calcaneus

目的:探讨跟骨外侧"L"型切口皮瓣血供与血管链的关系,探寻安全的手术切口。方法:解剖5具尸体标本,了解足外侧"L"型切口皮瓣的血管链供应情况。选取跟骨骨折10例,根据尸体解剖的结果,均采用外侧扩大"L"型切口切开复位接骨板内固定治疗跟骨骨折病例,观察病人的切口皮肤愈合状况。结果:腓动脉和胫前动脉在足外侧形成的血管链是"L"型切口皮瓣的主要血供来源。10例扩大"L"型切口皮瓣均成活良好,无伤口坏死、感染。结论:保护足外侧血管链可以避免对"L"型切口皮瓣血供的破坏,可以减少跟骨骨折外侧"L"型切口术后切口愈合不良的发生。

Objective:To explore the relationship between the blood supply of the lateral L-shaped incision flap of calcaneus and blood vessel chain,and probe the safe operative incision.Methods:Five cadaver samples were dissected to understand the blood vessel chain of L-shaped incision flap.According to the autopsy results,10 cases with calcaneus fractures were treated with enlarging lateral L-shaped incision of calcaneal combined with internal fixation of bone plate,and the incision healing of patients was observed.Results:The lateral blood vessel chain formed by peroneal and anterior tibial arteries was the main source of blood supply of L-shaped incision flap.The survival of enlarging lateral L-shaped incision of calcaneus was good in all cases,and no necrosis and infection were found.Conclusions:Protecting the lateral vessel chain of foot can avoid the damage of blood supply of L-shaped incision flap,and reduce the poor healing of lateral L-shaped incision of calcaneal.