外固定支架结合腓肠神经营养血管逆行岛状皮瓣转移治疗足跟软组织缺损  

Reversed sural neurocutaneous island flap combined with external fixation to repair the soft tissue defect in the heelstick

作　　者：贾鹏[1,2] 万春友[2] 舒衡生[2] 王凯[1] 

机构地区：[1]天津医科大学第二医院骨科,天津300211 [2]天津市天津医院骨科,天津300211

出　　处：《天津医科大学学报》2015年第2期143-146,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨外固定支架结合腓肠神经营养血管逆行岛状皮瓣转移治疗足跟软组织缺损的疗效。方法:应用组合式外固定支架及Ilizarov外固定支架结合腓肠神经营养血管逆行岛状皮瓣转移术修复足跟皮肤缺损16例。术前常规行创面分泌物细菌培养和药敏试验,术中彻底清创,再行腓肠神经营养血管逆行岛状皮瓣转移(皮瓣面积4 cm×6 cm^12 cm×9 cm),最后根据合并伤的不同选择适合的外固定支架固定。结果:所有病例均获得随访,随访时间5~36个月,平均12个月,16例皮瓣全部成活,皮瓣质地优良,耐磨,无明显挛缩,负重功能区未发生破溃及感染坏死。踝关节背伸0°~20°,跖屈30°~40°。结论:应用外固定支架结合腓肠神经营养血管逆行岛状皮瓣转移术治疗足跟软组织缺损,有利于皮瓣的成活和肢体功能的改善,能同时治疗足部骨折和矫正马蹄足畸形,可获得满意的临床疗效。Objective：To investigate the clinical effect of the reversed sural neurocutaneous island flap combined with external fixation to repair the soft tissue defect in the heelstick. Methods： Sixteen cases of the heelstick soft tissue defects were treated with the reversed sural neurocutaneous island flap combined with external fixation. The wound secretion bacteria cultures and drug sensitive test were performed on all patients before operation and thorough debridement, then the reversed sural neurocutaneous island flap was applied（area of flap 4cm×6 cm-12 cm×9 cm）. Finally, the adaptive external fixation according to associated injuries was used in operation. Results： All patients were followed up for 5 to 36 months, and the mean follow-up period was 12 months. The flaps of 16 cases all survived. All flaps were fine quality, Wear-resisting, without obvious contracture, no ulcer, infection or necrosis occurred in the weight area. The function of ankles were good, with the dorsal extension of 0° to 20°and the plantar flexion of 30° to 40°. Conclusion： The reversed sural neurocutaneous island flap combined with external fixation can improve the limb function and the flap survival with good clinical effect.

关 键 词：腓肠神经 皮瓣 外固定支架 足跟 缺损 

分 类 号：R68[医药卫生—骨科学]