跟腱延长联合腓肠神经营养血管皮瓣治疗瘢痕挛缩性足下垂畸形

Application of achilles tendon lengthening combined with sural neurovascular flap in the treatment of cicatricial drop foot

目的探讨跟腱延长联合腓肠神经营养血管皮瓣治疗瘢痕挛缩性足下垂畸形的效果。方法 2012年6月至2014年9月,北京积水潭医院烧伤科利用跟腱延长联合腓肠神经营养血管皮瓣治疗烧创伤后足下垂畸形患者6例,先行跟后侧切口、跟腱延长及内外踝下延长切口,矫正足下垂,继发的跟后侧创面用腓肠神经营养血管皮瓣覆盖。结果 6例患者术后足下垂畸形矫正,皮瓣完全成活,创面愈合。随访6~24个月无任何并发症,皮瓣外形满意,患者行走基本正常。结论对有条件可行腓肠神经营养血管皮瓣治疗的烧创伤后马蹄足畸形患者,跟腱延长联合腓肠神经营养血管皮瓣是治疗瘢痕挛缩性足下垂畸形的有效方法。

Objective To investigate the efficacy of achilles tendon lengthening combined with sural neurovascular flap for treatment of cicatricial drop foot. Methods Six patients with cicatricial drop foot were treated with achilles tendon lengthening combined with sural neurovascular flap in the depatment of burns,Jishuitan Hospital from June 2012 to September 2014. First,the skin incision of achilles was made,the achilles tendon lengthening and extended incision were made under internal and external ankle. The foot drop was correction. After the extension,the back wound of achilles was covered by sural neurovascular flap.Results Six cases of cicatricial drop foot deformity were correction,the flaps survived completely,the patients were followed-up 6-24 months with no complication. The flaps obtained good function and satisfactory outline. Conclusion Achilles tendon lengthening combined with sural neurovascular flap is an effective method for the treatment of cicatricial drop foot of the patient who has condition to use sural neurovascular flap.