腓骨皮瓣术后供区并发症研究进展  

Review ofthe complications of the donor site after fibular flap operation

作　　者：周喆刚 曾晖[2] ZHOU Zhegang;ZENG Hui(Shantou University Medical College,the Hand Microsurgery of Peking University Shenzhen Hospital,Guangdong Province,Shenzhen518036,China;The Orthopedics of Peking University Shenzhen Hospital,Guangdong Province,Shenzhen518036,China)

机构地区：[1]汕头大学医学院北京大学深圳医院显微手外科,广东深圳518036 [2]北京大学深圳医院骨科,广东深圳518036

出　　处：《中国当代医药》2022年第24期33-36,共4页China Modern Medicine

摘　　要：游离腓骨皮瓣手术是重要的伴有骨缺损及软组织缺损的修复手段,但供区并发症问题值得关注。骨筋膜室综合征早期表现有肿胀、疼痛、活动障碍等,必须高度警惕,如果出现亚临床筋膜室综合征表现时,需及时进行减压处理,并运用清创、二期缝合、植皮及皮瓣移植等手段积极救治。对于运动功能障碍,踝关节不稳定等远期并发症需以预防为主,优化供区切取和闭合方式,做到早发现、早诊断,积极处理,加强术后功能康复训练。对于拇趾屈曲挛缩等并发症可以采用肌腱松解延长等功能重建手术进行有效治疗。近年来,腓骨肌肉感觉检查、行走步态测试、光学分析、腿部功能的电生理分析等用于客观评价肢体功能障碍的量化标准均有报道,临床上又以踝关节外侧不稳定评分系统、Enneking下肢功能评价量表较为常用。本文就游离腓骨皮瓣术后常见供区并发症的病因、预防处理方法及后期功能训练等进行综述。The surgery of free fibular flap is an important operative method for the bone and flab defects,nevertheless,we should pay more attention for the complications of donor site which brings by the surgery of free fibular flap.The early manifestations of osteofascial compartment syndrome include swelling,pain,movement disorders,etc.which must be highly vigilant.If subclinical compartment syndrome occurs,decompression treatment should be carried out in time,and debridement,secondary suture,skin grafting and skin flap transplantation should be used to actively treat it.For long-term complications such as motor dysfunction and ankle instability,should focus on prevention,optimize the methods of surgical incision and closure,make the detection and diagnosis early,active the treatment,and strengthen the training of functional rehabilitation.For complications such as flexion contracture of thumb toe,the tendon release and extension reconstruction surgery can be used effectively.In recent years,objectively methods of limb dysfunction evaluate have been reported,such as fibula muscle sensory examination,walking gait test,optical analysis,electrophysiological analysis of leg function,but the commonly used methods are the ankle lateral instability scoring system and Enneking legs function evaluation scale clinically.This article reviews the etiology,prevention and treatment of common donor site complications after free fibular flap surgery,and the later functional training of the complications.

关 键 词：游离腓骨皮瓣术 供区并发症 修复手段 骨筋膜室综合征 

分 类 号：R622.1[医药卫生—整形外科]