带神经血管蒂腓骨长肌腱复合瓣修复跟腱并皮肤缺损  

The flap combining peroneus iongus muscle with nutrient vessels of nerve repairing the chronic achilles tendon rupture with the skin defect

作　　者：林松庆[1] 张发惠[1] 

机构地区：[1]南京军区福州总医院福建医科大学福总临床医学院骨一科,福州市350025

出　　处：《中华显微外科杂志》2007年第2期84-87,I0001,共5页Chinese Journal of Microsurgery

摘　　要：目的报道腓肠神经营养血管腓骨长肌腱复合瓣修复陈旧性跟腱断裂并皮肤缺损的治疗方法与效果。方法通过解剖学研究,切取以腓肠神经营养血管为蒂,串接腓骨长肌腱及足外侧皮瓣形成复合瓣,转移修复陈旧性跟腱断裂并皮肤缺损6例。皮肤缺损大小为6.5 cm×4.0 cm～2.0 cm×1.5cm;跟腱缺损长度为2.0～7.5 cm。结果术后随访4～16个月,皮瓣均成活及跟腱均愈合良好,皮瓣外观良好,未再破溃。术后1例皮肤边缘少部分坏死,1例少量伤口裂开,均经换药之后伤口愈合。根据Arner-Lindholm评定法,术后跟腱的功能,评定结果,本组优3例,良2例,可1例。结论应用腓肠神经营养血管腓骨长肌腱复合瓣修复陈旧性跟腱断裂合并皮肤缺损,可一次性修复皮肤及跟腱缺损,具有愈合能力及抗感染力强、力学性能与跟腱组织结构相近的优点,邻近转移,能满足跟腱重建的要求。Objective To explore the treatment methods and clinical result with the flap combining peroneus longus muscle supplying with the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect. Methods After anatomic investigating, Analyzing 6 cases. Excising peroneus longus muscle combining with the foot external flap, supplying with the podicle of the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect, among them, the size of flap was about 6.0 cm × 5.5 cm - 16. 5 cm × 11.0 cm, the defect length of achilles tendon 2. 0 -7.5 cm. Results All cases observed 4 to 16 months, all cases skin and achilles tendon were survived completely, the flap skin appearence was good, none ulcer. 1 cases part necrosis, 1 cases rerupture, Both healed after changed dressings. According to Arner-Lindholm criteria to test the efficacy the result were excellent in 3 patients, good in 2, poor in 1. Conclusion It is an ideal way using the flap combining peroneus logus muscle with the nutrient vessels of sural nerve repairing the chronic achilles tendon rupture with skin defect. The advantage is operting conveniently, transferred adjacently, repairing the skin and tendon defect simultaneously, healing fastly and anti-bacteria strongly, biomechanics property and function is similar to the heel, it can fit the heel and skin for repairing.

关 键 词：腓骨长肌腱 外科皮瓣 跟腱 修复 

分 类 号：R687.2[医药卫生—骨科学]