修薄股前外侧皮瓣移植治疗足踝创伤创面的疗效  

The effect of thinned anterolateral thigh flap transplantation for treatment of foot and ankle wounds

作　　者：周吉 杨效宁[2] ZHOU Ji;YANG Xiao-ning(Clinical College,Xuzhou Medical University,Xuzhou,Jiangsu 221004,China;Dept of Orthopaedics,the First People′s Hospital of Xuzhou City,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州医科大学临床学院,江苏徐州221004 [2]徐州市第一人民医院骨科,江苏徐州221002

出　　处：《临床骨科杂志》2021年第4期523-526,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨修薄股前外侧皮瓣移植治疗足踝创伤创面的疗效。方法将50例足踝创伤患者按照创伤修复方式不同分为观察组(采用修薄股前外侧皮瓣移植治疗,28例)和对照组(采用腓肠神经营养皮瓣转位治疗,22例)。比较两组皮瓣移植一次成活情况、创面愈合情况(创面愈合等级、创面愈合时间)、皮瓣外观优良率。采用Holden步行功能分级量表评价患者术后行走能力恢复情况,采用两点辨别觉法评价患者术后皮瓣感觉功能,采用健康状况调查问卷(SF-36评分)评价患者的生活质量。结果患者均获得6个月随访。皮瓣移植一次成活率、皮瓣外观优良率两组比较差异均无统计学意义(P> 0.05)。创面愈合情况、术后6个月皮瓣感觉功能观察组明显优于对照组(P <0.05)。Holden步行功能分级:术后3个月两组比较差异无统计学意义(P> 0.05);术后6个月观察组明显优于对照组(P <0.05)。术后6个月SF-36评分观察组明显优于对照组(P <0.05)。结论修薄股前外侧皮瓣移植治疗足踝创伤创面皮瓣成活率高,能够恢复患者行走能力,提高生活质量。Objective To investigate the effect of thinned anterolateral thigh flap transplantation in the treatment of foot and ankle wounds. Methods A total of 50 patients with foot and ankle wounds were divided into observation group( 28 cases were treated with thinned anterolateral thigh flap transplantation) and control group( 22 cases were treated with sural neurotrophic flap transposition),according to different wound repair methods. The disposable survival rate,wound healing condition( the grade and time of wound healing) and the excellent and good rate of flap appearance were compared between the two groups. Holden walking function grading scale was used to evaluate the recovery of postoperative walking ability,two-point discrimination method was used to evaluate the postoperative flap sensory function,and health status questionnaire( SF-36 score) was used to evaluate the quality of life of patients. Results All patients were followed up for 6 months. There were no significant differences in the disposable survival rate of flap transplantation and the excellent-good rate of flap appearance between the two groups( P > 0. 05);the wound healing and flap sensory function of postoperative 6 months in the observation group were significantly better than those in the control group( P < 0. 05). Holden walking function classification: the difference at 3 months after operation had no statistical significance between the two groups( P > 0. 05);the observation group was significantly better than the control group at 6 months after operation( P < 0. 05). The scores of SF-36 scale at 6 months after operation were significantly better than those in the control group( P < 0. 05). Conclusions The thinned anterolateral thigh flap transplantation for the treatment of foot and ankle wound has high survival rate,which can improve the recovery of walking ability,and improve the quality of life of patients.

关 键 词：股前外侧皮瓣 足踝创伤创面 腓肠神经营养皮瓣 行走能力 感觉功能 生活质量 

分 类 号：R622.1[医药卫生—整形外科] R641[医药卫生—外科学]