足骨及软组织创伤缺损的组合组织修复  

Repairation of defects of bones of foot and soft tissue by using composed tissue transfer

作　　者：王剑利[1] 付兴茂[1] 潘朝晖[1] 郭永强[1] 赵雁[1] 杨华山[1] 王成琪[1] 

机构地区：[1]中国人民解放军第八十九医院全军创伤骨科研究所,山东省潍坊市261000

出　　处：《中华显微外科杂志》2005年第3期197-199,共3页Chinese Journal of Microsurgery

摘　　要：目的研究解决足部创伤及疾病造成的足骨及软组织缺损的修复重建方法,减少和减轻足残疾和功能不良率,最大限度的恢复足功能和外型。方法对足背、前足、足跟、踝下等部位单纯软组织缺损,采用局部转移或旋转皮支皮瓣、筋膜皮瓣、游离皮瓣、全厚皮片植皮等方法修复;足底负重区采用预制皮瓣方法解决;前足、足跟及其它跗骨复合组织缺损采用带血管髂骨加皮瓣组织移植重建;内、外踝缺损应予以重建。结果247例经上述方法处理,临床疗效满意。按美国AOFAS踝-足评分标准:优84例,良107例,可42例,差14例。结论髂骨为一扁平伏骨,血运丰富,用于重建再造跖骨缺损尤其足多跖骨缺损、跟骨缺损时,接地稳定且触地面积大,便于负重、固定及承压。内、外踝可取带筋膜的髂骨和腓骨头重建骨及韧带缺损。组合带血管骨与皮瓣修复缺损,可将移植骨及皮瓣各自先充分对位满意后再行组合,较理想地恢复足的解剖和生理功能。Objective To study and discuss the methods for repairation and reconstruction of foot defects in order to reduce the deformity and insufficiency of foot and to restorat its functional and cosmetic aspects, Mehtods Soft tissue recovery was enough for digital absence, dorsal, submalleolus and calcaneous defect; Defects in plantar should be repaired with pre flap; Abstence of metatarsats head should be reconstructed by using vascularized bone incorporation with free flap transplantation, Results Total 247 cases with bone and soft tissue defects of foot were recpaired by using managements mentioned above achived satisfactory clinical result, All patiants were assed according to AOFAS of USA foot-malleolus scores, excellent 84 cases ;good 107 ; fair 42 ; poor 14, Conclusion Being flat in shape and abundant blood supply, the iliac bone is a valuable supply bone for foot defects espesial for muti-matatarsal and calcaneus. Absence of malleous should be reconstructed by free iliac bone or free febular head with fascial strip, Vascular bone incorporating with vascular flaps provided an ideal method of reconstruction foot conpound defects.

关 键 词：足骨 软组织创伤 软组织缺损 组织修复 

分 类 号：R658.3[医药卫生—外科学]