外踝后上外侧皮瓣修复跟骨骨折术后钢板外露  

Upper posterolateral flap of lateral malleolus to repair the steel plate exposure after calcaneal fracture operation

作　　者：冯鹏[1] 侯书健[1] 孙乐天[1] 王振军[1] FENG Peng;HOU Shujian;SUN Letian(Department of Hand Surgery Center,PLA 971 Hospital,Qingdao,Shandong,266071,China)

机构地区：[1]中国人民解放军第971医院全军手外科中心,山东青岛266071

出　　处：《实用手外科杂志》2018年第4期394-395,共2页Journal of Practical Hand Surgery

摘　　要：目的探讨采用外踝后上外侧皮瓣修复跟骨骨折术后皮肤坏死伴钢板外露的效果。方法 2007年1月-2017年1月,对18例创面采用VSD治疗1～2周,以外踝后方皮瓣为旋转点,在外踝后上外侧、小腿中部以下,根据受区创面大小设计切取皮瓣。结果本组18例18个皮瓣,皮肤缺损范围为8 cm×3 cm～3 cm×2 cm,皮瓣切取范围9 cm×4 cm～4 cm×3 cm,术后除1例远端部分坏死,经换药治愈外其余皮瓣全部成活,术后随访1～5年,骨折均愈合,皮瓣外形好,无臃肿,行走正常。结论外踝后上外侧皮瓣修复跟骨骨折术后皮肤坏死伴钢板外露创面,皮瓣血供可靠,设计灵活,切取范围缩小,明显减少了对小腿供区的损害,手术操作简单,疗效好,是修复足跟部软组织缺损最佳供区。Objective To explore the effect of the nutrient vascular flap of the terminal branch of the peroneal artery on the steel plate exposure after calcaneal fracture operation.Methods From Jan.2007 to Jan.2017,the wound in 18 cases were treated by VSD(the wound closed suction drainage)continuous suction for 1~2 weeks,with the posterior lateral malleolus flap rotation point,in the upper posterolateral area of the lateral malleolus,and below the middle calf,according to the size of wound,designed flap.Results This group of 18 cases with 18 skin flap,skin defect was in the range of 8 cm×3 cm×3 cm×2 cm,9 cm×4 cm×4 cm×3 cm flap,i case had distal partial necrosis and healed after dressing change.All the other flaps survived,postoperative follow-up of 1 to 5 years,all fractures healed,the flap appearance was good,no bloat,walking normal.Conclusion The upper posterolateral flap of lateral malleolus to repair postoperative skin necrosis with calcaneal plate exposure has the advantages of reliable blood supply,flexible design,small cutting range,significantly reduced damage of the donor site,simple operation,good curative effect,is the best dondr site to repair foot root soft tissue defect.

关 键 词：软组织缺损 跟骨骨折 外踝后上外侧皮瓣 修复 

分 类 号：R687.3[医药卫生—骨科学]