游离股前外侧穿支皮瓣修复踝关节周围软组织缺损  

Anterolateral thigh perforator free flaps for reconstruction of soft tissue defects around the ankle

作　　者：熊文化[1] 赵守军[1] 许柯[1] Xiong Wenhua Zhao Shoujun Xu Ke.(Department of Orthopedics, Second Hospital of Ningbo, Ningbo 315010, China)

机构地区：[1]宁波市第二医院骨科,315010

出　　处：《中华创伤杂志》2017年第7期646-650,共5页Chinese Journal of Trauma

摘　　要：目的探讨游离股前外侧穿支皮瓣修复踝关节周围软组织缺损的方法和临床效果。方法采用回顾性病例系列研究分析2010年1月-2016年6月收治的30例创伤性踝关节周围软组织缺损患者临床资料，其中男22例，女8例；年龄16—58岁[（41．5±1．2）岁]。软组织缺损面积9cm×4cm～23cm×12cm。均采用游离股前外侧穿支皮瓣修复创面。记录术后皮瓣血供稳定时间、皮瓣成活率、术后并发症、皮瓣二次整形率；按Baird—Jackson踝关节功能评分系统评价术后踝关节功能。结果患者均获随访6—24个月[（13．0±5．4）个月]。术后皮瓣血供稳定时间（6．5±1．1）d。29例皮瓣成活。术后1例因动脉血栓形成出现皮瓣坏死，1例出现动脉痉挛，1例出现静脉栓塞，1例因感染出现慢性窦道。无皮瓣行二次整形术。术后踝关节功能按Baird—Jackon评分系统评分：优25例，良5例。结论采用游离股前外侧穿支皮瓣修复创伤性踝关节周围软组织缺损，具有皮瓣易切取易成活、并发症少、再次整形率低、关节功能恢复好等特点。Objective To investigate the methods and therapeutic effects of anterolateral thigh perforator free flaps for reconstruction of soft tissue defects around the ankle. Methods A retrospective case series study was made on 30 patients treated with anterolateral thigh perforator free flaps for traumatic soft tissue defects around the tibia between January 2010 and June 2016. There were 22 males and eight females, with the age range of 16-58 years [ （41.5 ＋ 1.2） years~. Dimension of the soft tissue defect ranged from 9 cm x 4 cm to 23 cm ~ 12 cm. Flap stabilization time, flap survival rate, postoperative complications, second plastic surgery rate, and ankle joint function by Baird-Jackson score were recorded. Results All patients were followed up for （ 13.0 ＋ 5.4） months （ range, 6-24 months）. Time for flap stabilization was （6.5 -＋ 1.1 ） days. All flaps survived except in one patients with flap loss due to postoperative arterial thrombosis. Postoperatively, one patient had arterial crisis, one had venous thrombosis, and one presented sinus formation due to infection. No second plastic surgery was carried out. According to the Baird-Jackson score, the results were excellent in 25 patients and good in five. Conclusion Anterolateral thigh perforator free flaps for reconstruction of traumatic soft tissue defects around the tibia has advantages of easy harvesting and survival, less postoperative complications, less second surgery, and good function recovery.

关 键 词：踝损伤 软组织损伤 穿支皮瓣 

分 类 号：R658.3[医药卫生—外科学]