腓动脉主穿支蒂腓肠神经营养血管皮瓣修复跟腱区创面  

Modified sural neurocutaneous vascular flap based on single dominant perforator arising from peroneal artery for coverage of defects over achilles tendon

作　　者：陈雪松[1] 陈建明[2] 肖茂明[2] 王元山[2] 徐永清[3] 管力[2] 张黎明[2] 江珉[2] 李彦林[1] 

机构地区：[1]昆明医学院第一附属医院骨科,昆明650032 [2]解放军第五十九医院创伤显微外科 成都军区创伤显微外科中心 [3]成都军区昆明总医院全军骨科中心

出　　处：《中华整形外科杂志》2012年第1期22-25,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨应用改良腓肠神经营养血管皮瓣修复跟腱区创面的方法及疗效。方法设计切取以最低位腓动脉主穿支为蒂的矩形腓肠神经营养血管皮瓣，修复跟腱后皮瓣旋转180°，远、近端交换覆盖创面。供区一般直接缝合，个别病例需小面积全厚植皮。结果2005年6月至2008年10月临床应用15例，皮瓣切取面积13cm×15cm～18cm×9cm，均全部成活。术后随访10～17个月，足踝功能良好，外形轮廓接近正常。结论该皮瓣血供确切，修复后外形平整美观，利于正常穿鞋行走，适用于跟腱区创面缺损的修复。Objective To report the operative techniques and clinical results of specially designed sural neurocutaneous vascular flap pedicled on a dominant perforator （ the diameter ≥ 0.8 mm） of the peroneal artery for coverage of soft tissue defects overlying the Achilles tendon. Methods An approximately rectangular sural neurocutaneous vascular flap pedicled on the lowest dominant perforator arising from the peroneal artery was designed and harvested to repair defects over the Achilles tendon. The pedicle was located at a certain part of the flap, which divided the flap into the distal and the proximal parts. After the tendon was repaired, the flap was rotated 180° based on the perforator and the position of the distal and proximal parts of the flap was changed to cover the defects and part of the donor site respectively. In most cases, skin graft was not needed. Results The modified flaps were applied in 15 cases. All flaps（ ranged from 13 cm × 15 cm - 18 cm× 9 cm ） were transplanted successfully without necrosis, and no vascular problems occurred. Following up for 10-17 months showed both satisfactory functional and cosmetic results. Conclusions The modified flap has reliable blood supply and the special design provides nearly normal outline of the ankle which favorites shoe wearing. It＇ s an excellent option for covering defects overlying the Achilles tendon.

关 键 词：外科皮瓣 腓肠神经 跟腱 

分 类 号：R658.3[医药卫生—外科学]