踝管动脉穿支小腿皮瓣修复足部软组织缺损  

Distally based tarsal tunnel arterial perforator flap for skin defects in foot

作　　者：张发惠[1] 谢昀[2] 张朝春[1] 林松庆[1] 郑和平[1] 

机构地区：[1]南京军区福州总医院军区骨科研究所,福州350025 [2]福建医科大学附属第一医院骨科,福州350005

出　　处：《中国临床解剖学杂志》2015年第5期581-583,共3页Chinese Journal of Clinical Anatomy

基　　金：福建省自然科学基金(C0510034)

摘　　要：目的总结踝管动脉穿支皮瓣修复足部的软组织缺损效果。方法在踝管动脉穿支解剖学研究的基础上,2005年6月至2013年6月间临床采用踝管动脉穿支皮瓣修复足部的软组织缺损36例,致伤原因:车祸伤24例,砸伤12例。损伤部位:足背14例,足内侧22例,软组织缺损范围为5 cm×3 cm^16.5 cm×10.0 cm。皮瓣切取面积最小为6.0 cm×4.0 cm,最大为本组皮瓣切取范围为7 cm×5 cm^18 cm×12 cm,远端蒂旋转点位于平内踝。结果临床修复36例,创面Ⅰ期愈合33例,Ⅱ期愈合3例。所有病例经5~15个月随访,皮瓣色泽正常,外形与功能改善满意,供区创面植皮愈合良好,对功能无不良影响。结论踝管动脉穿支皮瓣,可以修复足部远侧创面,效果好。Objective To summarize the clinical effects of repairing skin defects in foot by distally based tarsal tunnel arterial perforator flap. Methods Between June 2005 and June 2013, based on the anatomic study of arterial perforators of tarsal tunnel, thirty-six patients with soft-tissue defects in the foot underwent reconstruction with the distally based tarsal tunnel arterial perforator flap. The etiology of injury：twenty-four cases were caused by traffic accident, two by crashing objects. The defect locations were as follows： fourteen at the dorsal foot, twenty-two at the medial margin of foot. The defect size ranged from 5.0 cm × 3.0 cm to 16.5 cm × 10.0 cm. The smallest dimension of the flap was 6.0 cm × 4.0 cm and the largest ranged from 7.0 cm × 5.0 cm to 18.0 cm × 12.0 cm. The rotation point of the distal pedicle was at the medial malleolus. Results 33 of total 36 cases obtained primary healing, and the other 3 obtained secondary healing. Postoperative follow-ups of the patients ranged from 5 to 15 months. All flaps survived completely with good color, and the appearance and function were satisfying. The donor site healed without morbidity after reconstruction with skin-grafting. Conclusion The distally based tarsal tunnel arterial perforator s flap is an ideal option for repairing soft tissue defects of distal segment of foots.

关 键 词：动脉穿支 隐神经 大隐静脉 踝管 远端蒂 

分 类 号：R322.72[医药卫生—人体解剖和组织胚胎学]