带髂胫束股前外侧穿支皮瓣修复足踝后区组织缺损  

Repair of tissue defect in the posterior malleolar area by anterolateral thigh perforator flap associated with the iliotibial band

作　　者：陈鑫 马光义 李刚强 宋振磊 祝海峰 王亚珂 宋力[2] CHEN Xin;MA Guangyi;Li Gangqiang(Department of Hand and Foot Surgery,Huaihai Hospital of Zhoukou,Zhoukou Henan,466000,Chin)

机构地区：[1]周口淮海医院手足外科,河南周口466000 [2]中国人民解放军第153中心医院全军创伤骨科中心,河南郑州450042

出　　处：《实用手外科杂志》2018年第2期204-207,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨应用带髂胫束股前外侧穿支皮瓣在足踝后区皮肤、跟腱缺损修复重建中的临床效果。方法 2013年7月-2015年10月收治足踝后区皮肤、跟腱组织复合缺损23例,均采用带髂胫束股前外侧穿支皮瓣修复,同时重建跟腱的缺损。其中男19例,女4例;年龄13～57岁。皮肤缺损范围11 cm×5 cm～33 cm×10 cm,跟腱缺损长度4～13 cm。急诊修复6例,Ⅱ期手术17例。结果 21例皮瓣全部成活,1例皮瓣术后出现静脉回流障碍;1例皮瓣下血肿形成,导致局部皮肤组织坏死,经换药、植皮手术后创面愈合。21例术后随访3个月～2年,皮瓣外形满意,跟腱抗应力性能好。根据AOFAS踝-后足评分,足踝功能恢复良好。结论应用带髂胫束股前外侧穿支皮瓣修复足踝后区皮肤、跟腱的缺损,临床效果满意。Objective To study the clinical effect of the anterolateral thigh perforator flap associated with the iliotibial band on the repair and reconstruction of skin and achilles tendon defects in the posterior malleolar area. Methods A total of 23 cases of patients with skin and Achilles tendon defects in the posterior malleolar area including 19 males and 4 females with the average age of 13 to 57 years were treated with the repair and reconstruction by the anterolateral thigh perforator flap associated with the iliotibial band in our hospital from July 2013 to October 2015. The range of skin defects was from 11 cm× 5 cm to 33 cm×10 cm and the lengths of achilles tendon defects were from 4 cm to 13 cm. Six patients underwent the emergency repair and 17 patients underwent the two-stage operation. Results The flaps of 21 cases survived completely and postoperative venous reflux disorder occured in the flap of 1 case. The hematoma formed under the flap in 1 case, causing local skin necrosis. After dressing and skin grafting, the wound healed. The follow-up was performed in 21 cases for 3 months to 2 years after operation, which found that the flap appearances were satisfactory and the stress resistance of achilles tendon was good. According to the AOFAS ankle-hindfoot score, the ankle function had a good recovery. Conclusion The clinical effect of the anterolateral thigh perforator flap associated with the iliotibial band on the repair and reconstruction of skin and achilles tendon defects in the posterior malleolar area is satisfactory.

关 键 词：股前外侧穿支皮瓣 髂胫束 足踝 组织缺损 

分 类 号：R658.3[医药卫生—外科学]