腓动脉外踝前终末穿支降支蒂岛状皮瓣修复中足和前足软组织缺损  

Clinical application of island flap with a pedicle of the descending branch of perforating branch from lateral anterior malleolus of peroneal artery in repairing midfoot and forefoot soft tissue defects

作　　者：秦建忠[1] 朱振华 周聚普[1] 周建东 QIN Jianzhong;ZHU Zhenhua;ZHOU Jupu;ZHOU Jiandong(Department of Hand and Foot Surgery,The Second Affiliated Hospital of Soochow University,Suzhou,Jiangsu Province 215004,China;Department of Foot and Ankle Surgery,Wuxi No.9 People's Hospital,Wuxi,Jiangsu Province 214062,China)

机构地区：[1]苏州大学附属第二医院手足外科,江苏苏州215004 [2]无锡市第九人民医院足踝外科,江苏无锡214062

出　　处：《中华显微外科杂志》2020年第1期20-23,共4页Chinese Journal of Microsurgery

基　　金：苏州大学附属第二医院科研预研基金项目(SDFEYBS1801);江苏省苏州市第十六批科技发展计划(民生科技)项目(SYS2018052);江苏省苏州市体育局体育科研局管课题项目(TY2016-203)。

摘　　要：目的探讨应用腓动脉外踝前终末穿支降支蒂岛状皮瓣修复中、前足软组织缺损创面的临床应用效果。方法自2010年1月至2016年12月,应用腓动脉外踝前终末穿支降支蒂岛状皮瓣修复中、前足软组织缺损5例。应用腓动脉外踝前终末穿支的降支与踝关节及跗骨窦周围血管网的吻合,皮瓣旋转点可低至跗骨窦附近,设计皮瓣逆行旋转后修复中、前足软组织缺损创面,其中皮瓣切取面积15 cm×12 cm^8 cm×6 cm。术后采用门诊及微信随访所有患者,观察记录皮瓣外观及受区肢体功能恢复情况。结果所有皮瓣均完全成活,无需二次手术。术后随访6~15个月,皮瓣质地优良,外形无臃肿,患肢踝关节活动度平均背屈15°,跖屈25°。结论以腓动脉外踝前终末穿支的降支为蒂的逆行岛状皮瓣可用于修复中、前足软组织缺损创面,皮瓣血运可靠,是修复中、前足软组织缺损创面的较好选择。Objective To explore clinical application of the island flap pedicled of the descending branch of perforating branch from lateral anterior malleolus of peroneal artery in repairing the soft tissue defects in midfoot and forefoot.Methods From January, 2010 to December, 2016, based on the anastomosis between the descending branch from a terminal branch of peroneal artery on the anterior aspect of the lateral malleolus and other branches located around the ankle joint and sinus tarsi, island flap with a pedicle could be harvested more distally and to be used in covering the soft tissue defects in midfoot and forefoot of 5 patients. Sizes of the flap were from 15 cm×12 cm to 8 cm×6 cm. All patients were followed-up in outpatient clinic or through WeChat. The appearance of the flaps and ankle function were recorded simultaneously.Results All flaps were survived without any secondary surgeries. During the follow-up of 6-15 months, the texture of flaps was good with satisfactory estheticity. Range of motion at the injured ankle was 15° in dorsi flexion and 25° in plantar flexion.Conclusion The flap with a pedicle of the descending branch of perforating branch from lateral anterior malleolus of peroneal artery is good enough to be used in the reconstruction of soft tissue defects in midfoot and forefoot.

关 键 词：腓动脉 终末穿支 岛状皮瓣 显微外科技术 

分 类 号：R65[医药卫生—外科学]