隐神经-大隐静脉营养血管远端蒂复合瓣的临床应用  

Clinical application of the compound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels

作　　者：柳昊[1] 叶澄宇[1] 魏立坤[1] 张怀保[1] 张发惠[2] 郑和平[2] 

机构地区：[1]浙江省温州医学院附属第一医院骨科,325000 [2]南京军区福州总医院军区临床解剖学研究中心

出　　处：《中华显微外科杂志》2006年第3期186-188,i0003,共4页Chinese Journal of Microsurgery

基　　金：浙江省温州市科技计划项目基金(Y2003A131)

摘　　要：目的研究设计隐神经-大隐静脉营养血管远端蒂复合瓣的方法和报道临床应用的疗效。方法利用隐神经-大隐静脉营养血管与肌、骨、皮营养血管同源的解剖学基础,形成小腿内侧隐神经-大隐静脉营养血管远端蒂复合瓣修复足踝部组织缺损8例。结果7例复合瓣创面Ⅰ期愈合,1例发生小面积皮肤坏死,经换药后创面Ⅱ期愈合。1例跟骨缺损Ⅱ期行髂骨植骨,术后12周X线片显示获得骨愈合。术后经3～12个月随访,复合组织瓣的质地、外观及功能良好。结论隐神经-大隐静脉营养血管远端蒂复合瓣血供可靠,不损伤主干血管,操作简单,肌瓣充填软组织缺损,骨膜瓣促进骨修复,皮瓣具有重建感觉的条件。Objective To explore the method of clinical application and the final result of the com- pound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels. Methods Basing on the anatomic basis that the nutrient vessels of saphenous nerve-great saphenous vein have the same derivation as the branches of the muscle, bone and skin. Eight cases of the tissue defects of ankles and feet were repaired by the flap. Results Seven cases were survived completely except the distal partly necrosis in one case. The calcaneal defects of one case were repaired by the iliac graft after two weeks of the operation. Follow up from 3 monthes to one year, the texture, appearance and function of the multiflap were good. Conclusion The compound flap of distally based of saphenous nerve-great saphenous vein nutritional vessels has the advantages as follow： the reliable blood supply, avoidance of sacrificing the major arteries, reconstruction of sensation and simply procedure. Besides, the defects of soft tissue and bone can be repaired on one operation.

关 键 词：隐神经 大隐静脉 复合组织瓣 修复 

分 类 号：R658.3[医药卫生—外科学]