游离腓骨复合组织瓣移植修复足第一跖骨与软组织缺损  

Transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot

作　　者：胡锐[1] 任义军[1] 严立 丁凡[1] 易新成[1] 韩琼[1] 勘武生[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院骨修复重建科,武汉430033

出　　处：《中华显微外科杂志》2016年第1期37-40,共4页Chinese Journal of Microsurgery

基　　金：湖北省卫计委科研项目（WJ2015MB155）

摘　　要：目的探讨游离腓骨复合组织瓣移植修复足第一跖骨与软组织缺损的疗效。方法2008年8月至2013年8月，采用游离腓骨复合组织瓣移植修复足第一跖骨与软组织重度缺损6例。致伤原因：车祸伤2例，机器绞伤4例；外伤性缺损3例，感染性缺损3例。移植复合组织瓣腓骨长度6．0—12．0cm，皮瓣面积8．0cm×5．0cm～18．0cm×16．0cm；所有病例术后3、6、12个月观察骨折愈合情况，1年后评估伤肢功能。结果术后随访12—24个月，平均14个月；皮瓣全部成活，半年即可见跖骨与腓骨瓣愈合良好；术后根据Maryland足功能评定标准，优2例．良4例。结论游离腓骨复合组织瓣移植修复足第一跖骨与软组织缺损，其具有创面覆盖满意一次性重建修复足部负重区及周围软组织缺损、缩短治疗周期、供区损伤小、修复后患足功能良好等优点。Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot. Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap. The causes： 2 cases in traffic accident injury, 4 cases in machine injury; 3 cases with traumatic defect, and septic defect in 3 patients. Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm; All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively. Results All cases were followed up 12-24 months, and average of 14 months; All the flaps survived, and the metatarsal bone and fibula heal- ing was good visibly in half a year; The surgery function were assessed according to Maryland＇s scale, and the excellent were 2 and the good were 4. Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.

关 键 词：足 腓骨瓣 骨移植 第一跖骨 显微外科 

分 类 号：R658.3[医药卫生—外科学]