顺行及逆行腓肠神经营养血管皮瓣的临床应用  

Clinical application of proximal or distal sural neurovascular flap

作　　者：杨朝晖[1] 刘利[1] 刘振武[1] 杨朝峰 尤月江[1] 颜继英[1] 王爱巧[1] 武润平[1] 

机构地区：[1]邯郸市中心医院骨一科,河北邯郸056001 [2]衡水市枣强县医院

出　　处：《中国骨伤》2006年第7期408-410,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨腓肠神经营养血管皮瓣顺行及逆行转移的临床特点。方法:应用顺行(4例)及逆行(15例)腓肠神经营养血管皮瓣修复下肢软组织缺损19例,男14例,女5例;年龄16~55岁。其中足背5例,足跟3例,踝部1例,胫骨远端6例,胫骨近端及膝部4例。8例为避免神经血管束与皮瓣脱套,连同少量腓肠肌纤维一起带入皮瓣;3例采用不带皮切取筋膜瓣的方式,以改善静脉回流。皮瓣切取面积6 cm×5 cm^16 cm×8 cm。结果:15例皮瓣成活,随访2个月~1年,皮瓣质地满意。2例部分坏死,2例皮瓣有水泡、边缘坏死或部分表皮坏死。结论:腓肠神经营养血管皮瓣血运丰富,覆盖范围广,是修复下肢软组织缺损的理想皮瓣。分离皮瓣时注意保护上下节段动脉的血供,同时改善皮瓣的静脉回流,可大大提高皮瓣的存活率。Objective：To study the clinical characteristics of proximal or distal sural neurovascular flap. Methods： 19 cases（ 14 males and 15 females, the age was 16 - 55 years） of soft tissue defect of lower extremity were repaired with proximal（4 cases） or distal （ 15 cases） sural neurovascular flap,including 5 cases in foot dorsum,3 in heel,1 in malleous ,6 in distal tibia,4 in knee and proximal tibia. Less gastrocnemius muscle fiber of 8 cases were put into flap in order to avoid sepavation of vascular bundle and flap;fascial flap without skin of 3 cases for amelioration of venous return. The area of flap was from 6 cm × 5 cm to 16 cm × 8 cm. Resuits：The flaps of 15 cases survived. Living flaps were followed-up from 2 months to 1 year, the result of the flaps were satisfactory. 2 flaps had partially necrosis;2 flaps had bubble and necrosis in edge or part scarfskin. Conclusion ： The sural neurovascular flap has sufficient blood circulation,it is an ideal flap for the repair of soft tissue defect of lower extremity. Protecting the arterial blood supply of the upper-lower segmental and improving veneus return during operation can increase flap survival rate.

关 键 词：腓肠神经 皮瓣 组织缺损 下肢 

分 类 号：R685[医药卫生—骨科学]