逆行隐血管蒂大收肌腱骨皮瓣修复髌韧带断裂并皮肤缺损

Repair of Fragmentation of Patella Ligament with Retroversal Flap of Great Adductor Muscle Tendon with Saphenous Artery

目的:报道以逆行隐血管为蒂大收肌腱骨皮瓣转位修复髌韧带断裂并皮肤缺损的新术式。方法:40侧经动脉灌注红色乳胶成人下肢标本上,解剖观测大收肌腱的形态及其血管的起源及分支分布特点,在2侧新鲜下肢标本上模拟手术设计。以逆行隐血管为蒂大收肌腱骨皮瓣转位修复髌韧带断裂并皮肤缺损5例。结果:术后随访18～48个月,大收肌腱骨皮瓣全部成活,疗效满意。结论:逆行隐血管蒂大收肌腱骨皮瓣与膝关节比邻,血供丰富,就近转位,操作简便,创伤小,可作为修复髌韧带并皮肤缺损的首选方法。

Objective:To report a new way for the treatment of fragmentation of patella ligament with skin defect by retroversal flap of great adductor muscle tendon with saphenous vessel. Methods: The shap of great adductor muscle tendon and the origin, branches and anastomosis of its vessels were observed on 40 low limbs of adult cadavers perfused with red latex, the procedure was designed on two fresh adult cadavers, and performed on five patients with fragmentation of patella ligament and skin defect. Results: All the flaps survived and satisfactory results were obtained after 18 to 48 months follow - up. Conclusion: The flap near to the acceptor has the advantages of rich blood supply, easy operation and less operative trauma, which can be chosen first for repair of fragmentation of patella ligament with skin defect.