旋髂深动脉蒂髂骨瓣联合腓肠神经营养血管皮瓣重建跟骨七例  

The experience for reconstructing calcaneus partial defect with deep iliac circumflex artery iliumiamella and sural nerve flap：7 cases report

作　　者：刘钢[1] 郑小罕[1] 潘廷[1] 

机构地区：[1]贵阳医学院附属医院急诊创伤外科,贵阳550004

出　　处：《中华显微外科杂志》2012年第4期282-284,I0006,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨带旋髂深血管的髂骨瓣联合腓肠神经营养血管皮瓣重建跟骨的治疗效果。方法自2005年7月至2010年7月，收治足外伤并跟骨缺损、足弓消失的7例患者，均采用带旋髂深血管的髂骨瓣游离移植，血管与胫后动脉端侧吻合，克氏针交叉固定髂骨重建跟骨，腓肠神经营养血管皮瓣覆盖跟骨，重建足跟皮肤。结果随访9-30个月，平均19．5个月。足弓无变形，Bohler角保持在35°-45°之间，足弓无塌陷，足跟皮肤耐磨，无破溃。根据美国Maryland足功能评分标准，优3例90分，良2例85分，中2例75分，均取得较满意的效果。结论带旋髂深血管的髂骨瓣游离移植，与残存跟骨愈合良好，腓肠神经营养血管皮瓣持久耐磨，是重建跟骨、重塑足弓，恢复足踝功能的良好措施。Objective To explore the surgical treatment effect reconstructing caleaneus partial defect with deep iliac circumflex artery iUium lameUa and sural nerve slap. Methods Sevens of calcaneus frac- ture with posterior part defect from July 2005 to July 2010 were rehabilitated with deep iliac circumflex artery ilium lamella whose artery were anastomosed to posterior tibial artery and whose skin were repaired with sural nerve slap. Results All patients were obtained follow-up, which ranged from 9 to 30 months with a mean of 19.5 months. Its Bohler angle maintain a range from 35 to 45 degree and foot bridge maintain its figure, as well as perfect skin. According to Maryland grades system, the result were excellent in 3 cases with score 90, good in 2 with score 85 and fair in 2 with score 75. Conclusion It is a perfect method for calcaneus trauma which lose its foot bridge to rehab its figure and function with deep iliac circumflex artery ilium lamella and sural nerve slap.

关 键 词：旋髂深动脉 髂骨瓣 跟骨缺损 显微外科手术 

分 类 号：R687.3[医药卫生—骨科学]