远端蒂携带筋膜皮下组织瓣的腓肠神经营养血管皮瓣修复跟腱断裂伴软组织缺损  

The distal pedicle carrying subcutaneous fascia sural nerve nutritional vessel axial flap in the treatment of achilles tendon rupture combined with soft tissue defect

作　　者：徐立伟 延静 张雪萍[1] 吕雷[1] 王新顺 鲜航 XU Li-wei;YAN Jing;ZHANG Xue-ping;LV Lei;WANG Xin-shun;XIAN Hang(1Dept of Hand and Foot Microsurgery,the 946th Hospital of PLA Land Force,Yining,Xinjiang 835000,China;Dept of Orthopaedics,the Affiliated Xijing Hospital of Air Force Medical University,Xi′an,Shaanxi 710032,China)

机构地区：[1]中国人民解放军陆军第九四六医院手足显微外科,新疆伊宁835000 [2]空军军医大学附属西京医院骨科,陕西西安710032

出　　处：《临床骨科杂志》2019年第5期570-573,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨远端蒂携带筋膜皮下组织瓣的腓肠神经营养血管皮瓣修复跟腱断裂伴软组织缺损的疗效。方法 急诊或二期应用远端蒂携带筋膜皮下组织瓣的腓肠神经营养血管皮瓣修复20例跟腱断裂伴有软组织缺损患者。结果 19例皮瓣全部成活,1例皮瓣边缘远端部分坏死,经换药后愈合。患者均获得随访,时间3~30个月。皮瓣质地良好,患者行走正常,踝关节功能正常。末次随访时根据Arner-Lindholm评定法评定跟腱功能:优16例,良3例,差1例,优良率19/20。结论 远端蒂携带筋膜皮下组织瓣的腓肠神经营养血管皮瓣切取简便,血运可靠,成活率高,修复跟腱断裂伴有软组织缺损疗效显著。Objective To investigate the clinical effect of distal pedicle carrying subcutaneous fascia sural nerve nutritional vessel axial flap in the treatment of achilles tendon rupture combined with soft tissue defect. Methods The 20 cases diagnosed as achilles tendon rupture combined with soft tissue defect were included,and distal pedicle and sural nerve nutritional vessel axial flap was chosen to cure the defect during emergency or the second-stage operation. Results The 19 flaps survived,and only one case of flap got edge necrosis,survived after dressings change. All cases were followed up for 3~30 months.The texture of the flaps was good.The patients walked well with normal ankle function.The function of the achilles tendon was evaluated by using the Arner-Lindholm evaluation criterion during the last follow-up,and the results were 16 cases excellent,3 cases good and 1 poor,with an excellent and good rate of 19/20. Conclusions The distal pedicle and sural nerve nutritional vessel axial flap has the advantages of easy incision,reliable blood supply,high survival rate and good repair effect on achilles tendon rupture combined with soft tissue defect.

关 键 词：跟腱断裂 软组织缺损 腓肠神经营养血管皮瓣 

分 类 号：R622.1[医药卫生—整形外科] R686.1[医药卫生—外科学]