胫后动脉内踝上穿支筋膜蒂皮瓣修复足踝部皮肤缺损  

Medial Supramalleolar Perforator-based Flap of Posterior Tibial Artery in Repairing Soft Tissue Coloboma of Foot and Ankle

作　　者：刘昌雄[1] 唐举玉[2] 刘鸣江[1] 谢松林[1] 李匡文[1] 吴攀峰[2] 朱孜冠[1] 

机构地区：[1]南华大学附属南华医院手外科,湖南衡阳421002 [2]中南大学湘雅医院骨科

出　　处：《南华大学学报（医学版）》2009年第5期555-557,共3页Journal of Nanhua University(Medical Edition)

摘　　要：目的探讨胫后动脉内踝上穿支筋膜蒂皮瓣在足踝部软组织缺损修复中的应用价值。方法2007年5月～2008年10月应用胫后动脉内踝上穿支筋膜蒂皮瓣修复足踝部软组织缺损13例，术前彩色超声多普勒行内踝上穿支探测并体表标记，在解剖学基础上，皮辩轴线在胫骨内侧髁后与内踝,跟腱间中点的连线，旋转点设计在穿支穿深筋膜处，深筋膜上游离皮瓣，术中可根据受区情况适当修整皮瓣厚度。结果13块皮瓣全部成活，术后随访3—6个月，皮瓣质地优良，外观满意。结论该皮瓣血运可靠，切取安全，不损伤主要血管，术中可修整皮瓣，术后外形好，是修复足踝部皮肤缺损的理想皮瓣。Objective To study the clinical application of medial supramalleolar perforator - based flap of posterior tibial artery in repairing foot and ankle soft tissue coloboma. Methods From May 2007 to Oct 2007, 13 cases of soft foot and ankle tissue coloboma were repaired or reconstructed with this flap. The perforator branch was detected and earmarked by Doppler ultrasound. The flap axis was designed as the connection of internal condyle of tibia and the middle point between inner malleolus and achilles tendon based on anatomy. The pivot was designed in the point which perforator branch perforate the deep fascia. The flap dissociation was performed upon the deep fascia and the flap thickness can be modified during the operation. Results After 3 - 6 months follow up, the flaps were survival with high quality and good appearance. Conclusion This kind of flap is an ideal flap in the repairing of ankle and foot soft tissue coloboma with sufficient blood supply, safe dissection, easy to modify and without sacrifice of major blood vessel.

关 键 词：穿支皮瓣 胫后动脉 软组织缺损 足踝部 

分 类 号：R628[医药卫生—整形外科]