胫后动脉穿支螺旋桨皮瓣修复儿童足跟部轮辐伤  

Posterior tibial artery perforator pedicled propeller flaps for children heel injuries in spoke wheel accident

作　　者：唐举玉[1] 俞芳[1] 吴攀峰[1] 周征兵[1] 肖勇兵[1] 庞晓阳[1] 曾磊[1] 潘丁[1] 卿黎明[1] 刘睿[1] Tang Juyu;Yu Fang;Wu Panfeng;Zhou Zhengbing;Xiao Yongbing;Pang Xiaoyang;Zeng Lei;Pan Ding;Qing Liming;Liu Rui(Department of Hand and Microsurgery Xiangya Hospital,CSU,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院手显微外科,长沙410008

出　　处：《中华整形外科杂志》2018年第8期636-639,共4页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金面上资助项目（81472104）

摘　　要：目的 探讨胫后动脉穿支螺旋桨皮瓣修复儿童足跟部轮辐伤所致皮肤软组织缺损的临床疗效.方法 2010年8月至2016年5月,采用胫后动脉穿支螺旋桨皮瓣修复儿童足跟部轮辐伤12例,皮肤软组织缺损面积为4 cm×3 cm～8 cm×3 cm,合并跟腱外露4例、跟腱部分缺损8例、部分跟骨缺损6例,跟腱缺损长度2～5 cm,平均3.2 cm,胫后动脉穿支螺旋桨皮瓣切取面积为8.0 cm×4.0 cm～ 12.5 cm×4.0 cm,6例携带筋膜瓣填充足跟腔隙,供区直接缝合11例、植皮1例.结果 12例皮瓣全部存活,无感染,术后随访3～20个月,平均8.5个月,皮瓣无臃肿,质地与周围皮肤接近,耐磨擦,无溃疡发生,踝关节功能满意.结论 胫后动脉穿支螺旋桨皮瓣具有血供可靠、供区损伤小、外观良好、手术操作简单、术后并发症少等优点,是一种修复儿童足跟部轮辐伤的理想方法.Objective To explore the clinic effects of posterior tibial artery perforator pedicled propeller flaps for children heel injuries in spoke wheel accidents.Methods During August 2010 and May 2016,12 children with spoke heel injuries were covered by posterior tibial artery perforator pedicled propeller flaps.The skin and soft tissue defects ranged from 4 cm × 3 cm to 8 cm × 3 cm.There were 4 cases with achilles tendon exposure,8 cases with achilles tendon defect in distal,6 cases with part of calcaneus defect.The range of achilles tendon defect were 2-5 cm （average 3.2 cm）.The flap size ranged from 8.0 cm ×3.0 cm to 12.5 cm ×4.0 cm.In 6 cases,fascia tissue was harvested to fill the heel cavity.The donor sites were closed directly in 11 cases,and covered with skin grafting in one case.Results All flaps survived smoothly with no complications.All patients were followed up 3 months to 20 months （mean,8.5 months）.The color and appearance of the flaps were satisfactory,with no impact on wearing shoes and walking.Conclusions Posterior tibial artery perforator pedicled propeller flap which has reliable blood supply,less donor-site morbidities,cosmetic shape,simple operation and less postoperative complications is an ideal method for surfacing heel spoke injuries in children.

关 键 词：螺旋桨 穿支皮瓣 足跟 儿童 

分 类 号：R726.2[医药卫生—儿科]