带蒂比目鱼肌瓣修复前足软组织缺损  

Repair soft-tissue defect in forefoot with reversed lateral soleus muscle flap

作　　者：张功林[1] 甄平[1] 陈克明[1] 赵来绪 杨军林 周建华 薛钦义 

机构地区：[1]兰州军区总医院全军骨科研究所,甘肃兰州730050 [2]武山县人民医院骨科,甘肃武山741300

出　　处：《中国骨伤》2017年第12期1127-1130,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨腓动脉为蒂逆行外侧半比目鱼肌瓣修复前足软组织缺损的临床疗效。方法 :自2005年1月至2013年1月,采用腓动脉为蒂逆行外侧半比目鱼肌瓣修复前足软组织缺损患者8例,其中男6例,女2例;年龄16~48岁,平均26.8岁。逆行外侧半比目鱼肌瓣转移至前足软组织缺损区,在肌瓣表面行Ⅰ期中厚网状游离植皮,供区直接缝合。术后观察肌瓣修复前足后成活情况。结果:肌瓣全部成活,术后没有发生血管危象,其中1例受区术后发生轻微的表浅感染,1例发生肌瓣远端小的植皮坏死,经2周换药处理自然愈合。术后随访2.5~5.5年,平均3.5年。受区外形较好。踝关节功能按Cedell标准评定,良6例,可2例。结论:当局部带蒂皮瓣或肌瓣应用受限时,外侧半比目鱼肌瓣修复后肌瓣成活较满意,很适宜修复前足软组织缺损。Objective：To summarize clinical application results of repair soft tissue defect in forefoot with a reversed lateral soleus muscle flap on peroneal artery pedicle. Methods：From January 2005 to January 2013,8 patients with soft-tissue defect on forefoot were underwent reconstruction with a reversed lateral soleus muscle flap on peroneal artery pedicle. There were 6 males and 2 female,aged from 16 to 48 years with an average of 26.8 years old. The reversed lateral soleus muscle flap was transposed to the forefoot defect area,then immediate coverage of the muscle flaps were performed by a meshed split thickness free skin graft. The donor site was closed directly. The muscle flap survey was observed after the repair of the forefoot.Results：All muscle flaps had survived completely. No clinical vascular deficiency was found on muscle flaps postoperatively.One case occurred recipient area sustained insignificant superficial infection,one patient developed distal muscle flap small skin graft necrosis,and spontaneous heal by 2 weeks＇ change dressing. Follow up period was ranged form 2.5 to 5.5 years with an average of 3.5 years postoperatively. A good contour was confirmed at the recipient area. According to Cedell questionnaire,6 patients obtained good results and 2 fair. Conclusion：When the local skin flap or muscle flap application is limited,lateral soleus muscle flap survey is satisfactory after repair and very suitable for repair of soft tissue defect of forefoot.

关 键 词：软组织损伤 外科皮瓣 修复外科手术 

分 类 号：R685[医药卫生—骨科学]