交腿比目鱼肌瓣带蒂移植修复对侧小腿软组织缺损  

Application of cross leg soleus muscle flap transplantation to treat the soft tissue defect in contralateral leg

作　　者：张功林[1] 甄平[1] 陈克明[1] 赵来绪 杨军林 周建华 薛钦义 

机构地区：[1]兰州军区总医院全军骨科研究所,甘肃兰州730050 [2]甘肃省武山县人民医院骨科,甘肃天水741300

出　　处：《中国骨伤》2015年第11期1052-1055,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：报告比目鱼肌瓣带蒂移植修复对侧小腿软组织缺损临床应用结果。方法：自2008年1月至2013年1月,应用比目鱼肌瓣移植修复对侧小腿软组织缺损8例,男7例,女1例;年龄20-49岁,平均31.8岁。损伤至手术时间：2-8周,平均46 d。肌瓣表面行Ⅰ期中厚网状游离植皮,供区直接缝合。结果：8例肌瓣全部成活,其中1例,受区创缘去除引流条后每天从引流孔有少量渗出液流出,经2周换药处理自然愈合。8例患者均获随访,时间1.5-4年（平均2.5年）。胫腓骨骨折全部愈合,受区外形较好。下肢功能按LEM标准评定,优2例,良5例,尚可1例。结论：比目鱼肌瓣带蒂移植很适宜伤肢仅有1条主要血管伴有软组织缺损的修复,可以减轻对供区的损伤。Objective：To summarize the clinical application results of the repair soft tissue defect in contralateral leg with a cross leg soleus muscle flap pedicle transplantation. Methods：From January 2008 to January 2013,8 patients with soft tissue defect in lower leg underwent reconstruction with a cross leg soleus muscle flap pedicle transplantation（without microvascular anastomoses）. There were 7 males and 1 female,aged from 20 to 49 years old with an average of 31.8 years. The operative time after injury was from 2 to 8 weeks with the mean of 46 days. The soleus muscle flap was transposed across to the contralateral leg defect area,then immediate to perform the coverage of the muscle flaps by a meshed split thickness skin graft. The donor site was closed directly. Results：All the muscle flaps had survived completely. In one case,recipient area edge had a less exudate from drainage hole everyday,the incision spontaneously was healed after 2 week＇s changing dressing. Follow up period ranged form 1.5 to 4 years with an average of 2.5 years postoperatively. The tibia and fibula fractures were healed well. A good contour was achieved at the recipient area. According to LEM standard,2 cases got excellent results,5 good and 1 fair. Conclusion：Soleus flap pedicle transplantation is very suitable to repair the soft tissue defect of the injuried leg only one main blood vessel,and can reduce the damage of donor area.

关 键 词：软组织损伤 外科皮瓣 带蒂肌瓣 

分 类 号：R658.3[医药卫生—外科学]