折叠腓骨瓣修复多跖骨缺损及文献回顾

Reconstruction of multiple metatarsal defects with fibula flap-case report and literature review

目的分析折叠腓骨瓣治疗多跖骨及皮肤软组织缺损的方法及效果。方法2016年9月-2018年10月,采用折叠腓骨瓣修复足部跖骨与大面积皮肤软组织缺损6例。结果术后复合组织瓣均顺利成活,创面一期愈合;供区植皮均成活,切口一期愈合。患者均获随访,随访时间6个月~2年,平均1.6年。X线片复查示,骨愈合时间为3.5~6个月,平均4.5个月。皮瓣质地柔软,颜色与周围正常组织相似。患者均行走正常。末次随访时,根据美国矫形足踝协会(AOFAS)足评分标准评定患足功能,优5例,良1例,优良率100%。结论折叠腓骨瓣修复多跖骨与大面积皮肤软组织缺损疗效良好。

Objective To analyze the method and effect of fibula flap in the treatment of multiple metatarsal and skin and soft tissue defects.Methods From September 2016 to October 2018,6 cases of foot metatarsal and large skin and soft tissue defects were repaired with fibula flap.Results After operation,the composite flaps survived with primary healing of wound;the skin grafts at donor site survived and the incision healed by first intention.All patients were followed up for 6 months to 2 years,with an average of 1.6 years.The reexamination of X-ray showed that the healing time of the bone was 3.5-6 months,with an average of4.5 months.The skin flap was soft and similar in color to the surrounding normal tissue.All patients walked normally.At the last follow-up,according to the foot score standard of the American association of orthopaedic foot and ankle(AOFAS),there were 3 excellent cases and 0 good cases with excellent and good rate of 100%.Conclusion Fibula flap is effective in repairing multiple metatarsal and large skin and soft tissue defects.