改良腓骨皮瓣在足跟缺损的解剖学基础及其初步应用  

The anatomical basis and clinical application of improved fibula flap in repairing the heel defect

作　　者：张树新 邹旭 许永先 邬慧萍 谭聪 邹阳平 詹森海 肖树斌 蒋彩霞 

机构地区：[1]佛山市南海区罗村医院,广东省佛山市528226

出　　处：《中华显微外科杂志》2016年第6期568-571,共4页Chinese Journal of Microsurgery

基　　金：佛山市卫生和计生局医学科研课题（20160202）

摘　　要：目的：探讨腓骨皮瓣的解剖基础及应用改良腓骨皮瓣修复足跟缺损的方法和疗效。方法采用20例成人下肢标本，红色乳胶灌注后，解剖观测腓动脉的来源、走行及分布范围。对2009年3月至2012年10月收治的6例足跟缺损的患者，临床上应用带骨膜、有血运的骨片垫于折叠腓骨下端的改良腓骨皮瓣修复足跟缺损，皮瓣切取面积5．0 cm x8．0 cm -12．0 cm x14．0 cm。结果腓动脉于腓骨头下方7．30（3．40-10．94） cm 开始贴紧腓骨走行并发出穿支，小腿中段穿支血管恒定，数目多，骨、皮穿支平均5（4-6）支，管径最大，皮穿支为1．14（0．92-1．58） mm，骨穿支为1．10（0．50-1．80） mm。临床上应用6例腓骨皮瓣全部成活，创面Ⅰ期愈合，移植腓骨、骨片均骨性愈合，未见明显吸收，随访6-36个月，平均12个月，皮瓣外形良好，质地柔软，足跟跖底处无溃疡、坏死，下肢行走正常。结论腓动脉起始、走行及分布恒定，带骨膜的骨片血运丰富，改良腓骨皮瓣是修复足跟缺损的理想方法。Objective To explore the methods and effects of using improved fibular flap to repair heel defect. Methods Adult leg specimens of 20 cases with red latex. Anatomical observation of the source of the peroneal artery, direction and distribution. In March, 2009 to October, 2012 6 cases of heel defect patients, were repaired with bone which with periosteum and blood supply mat in the folding of the bottom of fibula improved fibular flap The flaps area 5.0 cmx8.0 cm -12.0 cmx 14.0 cm. Results Peroneal artery to the fibular head below the 7.30（3.40-10.94）cm began with direction and fibula perforators, crus middle wear vascular constant, the number were much, bone, skin perforators with an average of 5 （4-6）, pipe diameter, the biggest skin perforators of 1.14 （0.92-1.58）mm, bone perforators was 1.10 （0.50-1.80）mm. Fibular flap survival all 6 cases, clinical Ⅰ healing of the wound, fibu-la transplantation, bone all osseous healing, no obvious absorption, were followed up for 6-36 months, an average of 12 months, flap good appearance, texture soft, heel plantar ulcers, necrosis, ascend a leg to walk normally. Conclusion Improvement of fibula flap is an ideal method to repair the heel defect cause the direction and the distribution of the peroneal artery are stable, and the periosteal bone blood supply is rich.

关 键 词：足跟缺损 腓骨皮瓣 再造 应用解剖 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学] R658.3[医药卫生—基础医学]