腓肠肌远端岛状肌瓣修复膝和小腿上2／3软组织缺损  

Clinical application of the distal island muscle flap of the gastrocnemius muscle for reparing the defects around knee and within the upper 2/3 of lower leg

作　　者：张功林[1] 龚铁军 赵来绪 王永恒 邹永刚 杨军林 

机构地区：[1]兰州军区总医院骨科研究所,730050 [2]甘肃张掖市医院骨科 [3]甘肃武山县医院骨科

出　　处：《中华整形外科杂志》2010年第5期328-331,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨应用腓肠肌远端岛状肌瓣修复膝关节周围和小腿上2／3软组织缺损的临床效果。方法2003年5月至2009年5月，应用腓肠肌远端岛状肌瓣修复18例膝关节周围和小腿上2／3软组织缺损，其中腓肠肌内侧头远端岛状肌瓣12例，腓肠肌外侧头6例。肌瓣表面以中厚网状皮片修复，供区直接缝合。结果18例患者的肌瓣和其上所植皮片均成活，仅有2例术后创缘表浅感染，但经换药后逐渐愈合。术后随访8个月至4．8年，平均3．5年，供区愈合良好，仅有一纵行手术切15痕迹。患肢膝关节屈、伸与小腿内、外旋，以及足的跖屈与站立时上提足跟的肌力强度与功能，与健肢相比无明显差异，未见明显的功能障碍。受区肌瓣质地、厚薄及颜色均较好。结论腓肠肌远端岛状肌瓣血供丰富，血管解剖恒定，血管蒂长，肌瓣较薄，适宜修复膝关节周围和小腿上2／3软组织缺损。Objective To summarize clinical application of the distal island muscle flap of the gastrocnemius muscle for reparing the defects around knee and within the upper 2/3 of lower leg. Methods 18 patients with defects around knee and within the upper 2/3 of lower leg, were treated with the distal island muscle flap of the gastrocnemius muscle, including 12 cases with medial muscle head and 6 cases with lateral muscle head. The muscular flaps were covered with meshed split-thickness skin grafts. The wound at donor sites were closed directly. Results All the skin grafts and muscle flaps survived with superior infection at the wound edge in two cases. The patients were followed up for 8 months to 4.8 years with satisfactory cosmetic and functional results. Conclusions The distal island muscle flap of the gastrocnemius muscle has a reliable blood supply, long pedicle and suitable thickness. It is an ideal method for repairing the defects around knee and within the upper 2/3 of lower leg.

关 键 词：肌瓣 带蒂移植 缺损 

分 类 号：R658.3[医药卫生—外科学]