低旋转点隐神经营养血管远端蒂皮瓣修复儿童大面积足跟部贴骨瘢痕的效果  

Efficacy of repairing large area heel scar with distally based saphenous neurocutaneous skin flap in children

作　　者：王建祥[1] 金宝城[1] 于力[1] 王青松[1] WANG Jianxiang JIN Baocheng YU Li et al.(Department of Orthopedics, Chengde Central Hospital, Chengde 067000, CHIN)

机构地区：[1]承德市中心医院骨二科,河北省067000

出　　处：《江苏医药》2017年第12期869-870,F0003,共3页Jiangsu Medical Journal

摘　　要：目的观察低旋转点隐神经营养血管远端蒂皮瓣修复儿童大面积足跟部贴骨瘢痕的临床效果。方法大面积足跟贴骨瘢痕患儿9例,年龄5~13岁;出现瘢痕至修复间隔时间4个月~4年;足跟瘢痕面积4cm×5cm^11cm×15cm。采用低旋转点隐神经营养血管远端蒂皮瓣修复足跟瘢痕,术后24~36h拔除引流。3周左右开始行皮瓣蒂部夹蒂延迟训练;4周左右断蒂,并开始功能锻炼。结果术后随访6~27个月,转移皮瓣全部成活;足跟部移植皮瓣质地松软不臃肿,外形满意,穿鞋行走局部皮肤无破溃。踝关节活动范围:背伸5~30度,跖屈8~35度。2例感觉恢复差。结论低旋转点隐神经营养血管远端蒂皮瓣修复儿童大面积足跟部贴骨瘢痕效果良好。Objective To observe clinical efficacy of repairing a large area heel scar with distally based saphenous neurocutaneous skin flap in children.Methods Nine children（aged 5 to 13 years old）with large area heel scar were repaired with distally based saphenous neurocutaneous skin flap.The interval from scar formation to repairment was 4 months to 4 years.The area of scar was 4cm×5cm to 11cm×15cm.The drainage tube was pulled out 24 to 36 hours after operation.The training of pedicle clamping and delaying started about 3 weeks late.The pedicle was cut off about 4 weeks after surgery and function exercise was started.Results The patients were followed up for 6 to 27 months,which showed that all flaps were survived,soft and loose with satisfactory appearance.No ulceration was seen when walking with shoes.The movement of the ankle joint was in the ranges of 5 to 30 degrees for dorsiflexion and 8 to 35 degrees for plantar flexion.Two cases had less sensation.Conclusion Clinical efficacy of repairing a large area heel scar with distally based saphenous neurocutaneous skin flap in children is satisfactory.

关 键 词：隐神经 皮瓣 足跟瘢痕 儿童 

分 类 号：R726[医药卫生—儿科]