游离股前外侧穿支皮瓣修复踝关节周围软组织缺损的效果分析  

Effect of anterolateral thigh perforator flap in repair of soft tissue defect around the ankle joint

作　　者：陈卓 张家平 何小庆 王凡 柴琳琳 杨青青 陈亮 CHEN Zhuo;ZHANG Jia-ping;HE Xiao-qing;WANG Fan;CHAI Lin-lin;YANG Qing-qing;CHEN Liang(Department of Plastic and Aesthetic Surgery,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院整形外科,重庆400038

出　　处：《局解手术学杂志》2020年第5期386-389,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：军事医学高新技术培育项目(CX2019JS102)。

摘　　要：目的探讨游离股前外侧穿支皮瓣修复踝关节周围软组织缺损的效果。方法回顾性分析陆军军医大学第一附属医院2015年1月至2019年1月收治的41例踝关节周围软组织缺损患者的临床资料。所有患者均采用游离股前外侧穿支皮瓣进行修复治疗。观察其治疗情况,比较治疗前后的AOFAS踝-后足评分、感觉功能、外形满意度。结果本组患者的手术时间、住院时间、治疗费用分别为(144.62±10.57)min、(18.03±1.12)d、(1.51±0.33)万元,皮瓣存活率为97.56%,且无皮瓣二次整形情况发生;患者治疗后AOFAS踝-后足评分、外形满意度均高于治疗前,差异具有统计学意义(P<0.05);患者治疗前后的S0级、S1级、S3+S3++S4级感觉功能情况比较,差异具有统计学意义(P<0.05)。结论游离股前外侧穿支皮瓣修复治疗踝关节周围软组织缺损患者,皮瓣存活率较高,可促进关节功能和感觉功能的有效恢复。Objective To study the effect of anterolateral thigh perforator flap in repairing soft tissue defect around the ankle joint.Methods The clinical data of 41 patients with soft tissue defect around the ankle joint who were admitted into the first affiliated hospital of army medical university from January 2015 to January 2019 were analyzed retrospectively.All patients were treated with anterolateral thigh perforator flap.The AOFAS ankle hindfoot scale,sensory function and appearance satisfaction were compared before and after treatment.Results The operation time,hospitalization time,treatment cost and flap survival rate were(144.62±10.57)minutes,(18.03±1.12)days,(15100±3300)yuan and 97.56%respectively,and there was no case of flap secondary plastic surgery.The AOFAS ankle hindfoot scale and appearance satisfaction of patients after treatment were higher than those before treatment,the differences were statistically significant(P<0.05).The sensory function of S0,S1 and S3+S3++S4 before and after treatment were compared,the differences were statistically significant(P<0.05).Conclusion Anterolateral thigh perforator flap can improve the survival rate of the flap and promote the effective recovery of joint function and sensory function for patients with soft tissue defect around the ankle joint.

关 键 词：踝关节 软组织缺损 皮瓣修复 关节功能 感觉功能 股前外侧血管穿支 AOFAS踝-后足评分 

分 类 号：R274.32[医药卫生—中医骨伤科学]