腓肠肌内侧头肌皮瓣修复膝部软组织缺损

Repair of knee soft tissue defect with medial gastrocnemius cephalic myocutaneous flap

目的总结应用腓肠肌内侧头肌皮瓣顺行转移修复膝部软组织缺损的临床疗效。方法2015年1月至2018年5月广西壮族自治区贵港市中西医结合骨科医院采用腓肠肌内侧头肌皮瓣顺行转移修复膝部软组织缺损7例,切取皮瓣面积3.5cm×6.0cm^7.5cm×13.0cm。结果7例皮瓣均成活,1例因术后蒂部肿胀卡压,拆除部分缝线解压后皮瓣肤色逐渐恢复正常;1例术后有轻微感染,经抗感染及换药治疗后愈合。7例均获得了随访,随访时间6~15个月,皮瓣外形及色泽满意,无明显臃肿。结论腓肠肌内侧头肌皮瓣血供可靠,顺行修复膝部软组织缺损手术操作简单,术后护理简便,不影响膝踝关节功能,易于在基层医院推广。

Objective To summarize the clinical effect of anterograde transfer of medial gastrocnemius cephalic myocutaneous flaps for repairing knee soft tissue defects. Methods From January 2015 to May 2018, 7 cases of knee soft tissue defects in Guangxi Guigang Integrative Traditional Chineseand Western Medicine Orthopedic Hospital were repaired by anterograde transfer of medial gastrocnemius cephalic myocutaneous flaps. The maximum area of flaps was 7.5 cm × 13.0 cm, and the minimum was 3.5 cm × 6.0 cm. Results Seven cases of flaps survived and 1 case recovered gradually after decompression due to swelling and compression of the pedicle. The other case had slight infection and healed after anti-infection and dressing change. Seven cases of them received follow-up from 6 months to 15 months. The shape and color of the flaps were satisfactory and there was no obvious swelling. Conclusions The blood supply of medial gastrocnemius cephalic myocutaneous flaps is reliable, the operation of anterograde repair of knee soft tissue defect is simple, the nursing after operation is simple, and the function of knee and ankle joint is not affected. It is easy to be popularized in grass-roots hospitals.