腓肠神经逆行皮瓣修复足踝及胫前软组织缺损

Repair of the soft tissue defects of the foot and the ankle and the anterior tibia with the sural nerve pedicle flap

目的研究足踝及胫前软组织缺损采用腓肠神经逆行皮瓣的修复方法。方法采用腓肠神经逆行皮瓣修复20例足踝部软组织缺损、7例胫前软组织缺损患者,修复缺损大小3cm×4cm～8cm×11cm。结果有1例发生皮瓣边缘部分坏死,清创换药后愈合,所有病例随访6个月～2年,3例外形臃肿,但均恢复正常的劳动。结论腓肠神经逆行皮瓣的血管恒定,变异小,不牺牲主要血管,蒂部可有足够的长度,可恢复局部的皮肤感觉,操作安全,供区不残留功能障碍,是修复胫前及足踝部软组织缺损的理想方法。

Objective To explore the clinical ways to repair soft tissue d efects around the foot, ankle and anterior tibia by using sural nerve pedicle fl ap. Methods The sural nerve pedicle flaps were used to repair soft tissue defect s around the foot and ankle (20 cases), and anterior tibia (7 cases ). The size of the repair ranged from 3×4cm to 8×11cm. Results Partial necrosis occurred a round the flap edge in one case, but then healed with debridement and dressing change. All cases were followed up from six months to two years. They recovere d to normal working condition, but 3 cases had abnormal shapes. Conclusion Becau se the sural nerve pedicle flaps have stable blood vessels and the axis of the f lap has enough length, the sense of local skin can be easily restored and the op eration can be done safely so that no dysfunction will occur in the supply area. Therefore, it is an ideal method to repair soft tissue defects around the foot, ankle and anterior tibia with sural nerve pedicle flaps.