小腿外侧穿支皮瓣修复跟骨外露的临床效果

Clinical application of the lateral perforator flap of leg to repair calcaneal exposure of the lower leg

目的探讨小腿外侧穿支皮瓣修复足外伤后跟骨外露的临床效果。方法选取2015年1月-2017年12月收治的6例外伤致跟骨外露患者,早期行清创,Ⅱ期应用小腿外侧穿支皮瓣修复跟骨外露创面。结果术后皮瓣均Ⅰ期愈合,未出现血管危象等并发症。随访3~13个月(平均5个月),皮瓣颜色、外形、质地、弹性、血运、感觉良好,创面未见明显瘢痕挛缩,行走及运动时无疼痛,未因摩擦出现破溃现象。结论小腿外侧皮瓣供区与受区邻近、血管恒定、切取方便、皮肤质地良好,可直接缝合或植皮覆盖供区,同一麻醉平面即可手术,是修复足外伤后跟骨外露的一种理想方法。

Objective To investigate the effect of the lateral perforator flap of the lower leg to repair calcaneal exposure after foot trauma. Methods From Jan 2015 to Dec 2017, there were 6 patients whose calcaneals were exposed after trauma, 1 was hurted by production machine, 5 were hurted in car accident. in order to repair, we had to do debridments at the early time, then to repair the exposed calcaneals through the lateral perforator flap of the lower leg. Results The flaps of 6 patients all survived successfully, there was no vascular crisis, the postoperative wounds were well covered. Followed up for 3~13 months, with an average of 5 months, the flaps were well in color, shape, texture, elasticity, blood surply and feeling. There was no obvious scar contracture on the wounds, no pain during walking, and no ulcer was caused by friction. Conclusion The lateral perforator flap of the lower leg, is adjacent to recipient site, the skin texture、 blood vessel is constant, and easy to be obtained. We can suture directly or make skin grafts on the donor area. The same anesthetic plane can be necessary for operation, which is an perfect method to cover calcaneal exposure.