单蒂旋转腓肠神经逆行岛状皮瓣修复小腿远端及足踝部软组织缺损  

Repairing distal leg and foot-ankle soft tissue defect with rotated single pedicel reverse sural neurocutaneous island flap

作　　者：张艳茂[1] 刘会仁[1] 于占勇[1] 张瑞红[1] 马铁鹏[1] 孙汝涛[1] 刘建华[1] 王岩[1] Zhang Yanmao Liu Huiren Yu Zhanyong Zhang Ruihong Ma Tiepeng Sun Rutao Liu Jianhua Wang Yan(Department of Hand Surgery, the Second Hospital of Tangshan, Hebei Tangshan 063000, Chin)

机构地区：[1]河北省唐山市第二医院手外科,063000

出　　处：《中国医师进修杂志》2017年第8期748-751,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨应用单蒂旋转腓肠神经逆行岛状皮瓣修复小腿远端及足踝部软组织缺损的手术方法及临床效果.方法 回顾性分析2011年6月至2016年1月应用单蒂旋转腓肠神经逆行岛状皮瓣修复17例小腿远端及足踝部软组织缺损患者的临床资料.男13例,女4例;年龄25~65（42.0＆#177;8.3）岁.小腿远端7例,踝部3例,足跟3例,足背4例.软组织缺损面积3.0 cm＆#215;4.5 cm^6.0 cm＆#215;12.0 cm,皮瓣切取面积5.0 cm＆#215;7.0 cm^8.0 cm＆#215;15.0 cm.均有骨、肌腱等深部组织外露.结果 17例患者皮瓣全部成活,无坏死及水泡形成,无血管危象发生.所有患者经12~48（20.0＆#177;11.1）个月随访,皮瓣质地柔软,皮肤色泽、弹性良好,外形满意.皮瓣供区功能及外观无影响.结论 单蒂旋转腓肠神经逆行岛状皮瓣,不损伤主要动脉及神经,蒂部＆quot;无效＆quot;折叠少,旋转弧度大,成活率高,手术操作简单,疗效满意,是修复小腿远端及足踝部软组织缺损的有效方法之一.Objective To evaluate the outcomes of distal leg and foot-ankle reconstruction with rotated single pedicel reverse sural neurocutaneous island flaps. Methods From June 2011 to January 2016, seventeen distal leg and foot-ankle defects cases repaired with rotated single pedicel reverse sural neurocutaneous island flap were analyzed retrospectively. In this study, 13 cases were male, and 4 cases were female. Age ranged from 25 to 65 years old, with an average age of 42.0 ＆#177; 8.3 years. Seven cases were distal leg defects, 3 cases were ankle defects, 3 cases were heel defects, and 4 cases were acrotarsium defects; all cases had bone and tendon exposure. The defects ranged from 5.0 cm ＆#215; 7.0 cm-6.0 cm ＆#215; 12.0 cm. The flap size ranged from 5.0 cm ＆#215; 7.0 cm-8.0 cm ＆#215; 15.0 cm. Results All 17 cases survived completely, without thanatosis, blisters and vascular crisis. The follow-up period was 12-48 months, and the mean was （20.0 ＆#177; 11.1） months. The color and elasticity of the flaps was excellent, with satisfactory appearances. Function and appearance of donor sites was not affected. Conclusions The rotated single pedicel reverse sural neurocutaneous island flaps have no injury on main nerves and arteries. The flaps have wide rotation angle and less invalid fold in the pedicel. The simple operation has satisfactory effects and high survival rate. It is a relatively easy procedure that can be applied toward repairing of distal leg and foot-ankle soft tissue defect.

关 键 词：腓肠神经 外科皮瓣 软组织损伤 

分 类 号：R658.3[医药卫生—外科学]