隐神经营养血管蒂逆行岛状皮瓣修复前足软组织缺损17例临床报告  

Repairing Soft Tissue Defect of the Forefoot with the Reversed Saphenous Neurocutaneous Vascular Pedicle Island Flap

作　　者：孙晋客[1] 王年芳[1] 韩明涛[1] 

机构地区：[1]山东省文登整骨医院,山东文登264400

出　　处：《中国中医骨伤科杂志》2011年第5期31-32,共2页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的：探讨隐神经营养血管蒂逆行岛状皮瓣修复前足软组织缺损的可行性及临床疗效。方法：2005年2月-2009年12月,对17例前足部软组织缺损患者行隐神经营养血管蒂逆行岛状皮瓣修复术,其中5例将隐神经断端与创面内皮神经相吻合。结果：皮瓣切取面积最大为9cm×11cm,最小为5cm×7cm,平均平均7.2cm×9.2cm;蒂长10-14cm。15例皮瓣全部成活,2例皮缘发生浅表性坏死。经6个月-3年随访,皮瓣外形满意、富有弹性、耐磨;所有患足步态正常,无继发性溃疡形成。5例行神经吻合皮瓣,两点辨别觉达8-12mm,恢复保护性感觉。结论：隐神经营养血管蒂逆行岛状皮瓣取材方便,血供可靠,不牺牲主要动脉,是修复前足部软组织缺损的一种良好方法。Objective：To explore the feasibility and the clinical effect of the reversed saphenous neurocutaneous vascular pedicle island flap for repairing soft tissue defect of the forefoot.Methods：From February 2005 to December 2009,17 cases with soft tissue defect of the forefoot were repaired with the reversed saphenous neurocutaneous vascular pedicle island flap.The stump of saphenous nerve was anastomosed with cutaneous nerve in the recipient site in 5 cases.Results：The areas of transferred flaps were ranged from 5×7cm to 9×12cm,with the average of 7.2×9.2cm.The pedicles were 10～14cm in length.All 15 flaps were survived,unfortunately,2 cases took place superficial necrosis.They were followed up for 636 months.The appearance,texture,and function of the flaps were satisfactory.The walking patterns were normal without secondary ulceration.The protective sensibility was recovery in 5 cases with nerve anastomosis,and the two-point discrimination of the flaps was 8-12mm.Conclusion：The reversed saphenous neurocutaneous vascular pedicle island flap is effective for repairing soft tissue defect of the forefoot for its advantages of reliable blood supply,no sacrifice of vascular trunk,and favorable texture.

关 键 词：前足 隐神经 外科皮瓣 软组织缺损 

分 类 号：R685[医药卫生—骨科学]