腓肠肌内侧头联合内侧半比目鱼肌瓣转移修复胫骨近端骨外露创面的临床效果  

Medial head of the gastrocnemius combined with medial hemi-soleus muscle flap transfer to repair proximal tibial bone exposure

作　　者：张功林 师富贵 王行高 冯致举 何如祥 胡军 孙萍 岳孝太 赵文学 王伟世 Zhang Gonglin;Shi Fugui;Wang Xinggao;Feng Zhiju;He Ruxiang;Hu Jun;Sun Ping;Yue Xiaogtai;Zhao Wenxue;Wang Weishi(Department of Hand Surgery,Lanzhou Hand and Foot Surgery Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省兰州市兰州手足外科医院手外科,兰州730050

出　　处：《中华临床医师杂志（电子版）》2020年第10期790-794,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：兰州市科学技术局项目(2018-4-60)。

摘　　要：目的总结腓肠肌内侧头联合内侧半比目鱼肌瓣转移修复胫骨近端骨外露创面的临床效果。方法2012年1月至2018年1月,16例患者胫骨近端骨外露创面采用腓肠肌内侧头联合内侧半比目鱼肌瓣转移术治疗。男11例,女5例;年龄20~46岁,平均37岁。胫骨近端骨外露创面范围为(12.0 cm×11.0 cm)^(16.5 cm×14.0 cm)。双肌瓣修复胫骨近端骨外露创面后,肌瓣表面行一期中厚网状游离植皮,供区创面直接缝合。结果术后所有肌瓣全部成活,肌瓣没有发生血管危象。有1例发生受区小的植皮坏死,经游离植皮修复后愈合。术后随访2.5~4.5年,平均3.5年,骨折愈合牢固。受区和供区外形较好,取得了较满意的效果。结论该方法适用于修复胫骨近端较大的骨外露创面,减轻了对供区的损伤。Objective To observed the clinical effects of the medial head of the gastrocnemius combined with medial hemi-soleus muscle flap transfer to repair proximal tibial bone exposure wound.Methods Between January 2012 and January 2018,16 patients with proximal tibial bone exposure wound were treated by transposition of the medial head of gastrocnemius combined with medial hemi-soleus muscle flap.There were 11 males and 5 females,aged from 20 to 46 years(mean,37 years).The size of the proximal tibial bone exposure wound ranged from 12.0 cm×11.0 cm to 16.5 cm×14.0 cm.After repairing the proximal tibial bone exposure wound with double muscle flaps,the muscle flaps were repaired withy a meshed split-thickness skin graft.The wound of the donor site was closed directly.Results All the muscle flaps survived completely.No clinical vascular deficiency was found on the muscle flaps postoperatively.In one case,the skin grafts in the recipient area had small necrosis and were healed with free skin grafts.The follow-up period ranged from 2.5 to 4.5 years(mean,3.5 years).A good contour was confirmed at both the recipient and donor sites.The tibia and fibula fractures had confirmed healing.Satisfactory clinical results were obtained in this series.Conclusion The medial head of the gastrocnemius combined with medial hemisoleus muscle flaps are suitable for the repair of the proximal tibial large bone exposure wound and reduce the damage to the donor site.

关 键 词：胫骨 腓肠肌 比目鱼肌 创面 肌瓣 

分 类 号：R687.2[医药卫生—骨科学]