股前外侧肌皮瓣治疗足踝部慢性骨髓炎9例治疗体会  

Experience with anterolateral femoral flaps in treating nine cases of chronic osteomyelitis of the foot and ankle

作　　者：周荣 刘禹城 巨积辉 张韬 程俊楠 杨亮 郭礼平 刘跃飞 Zhou Rong;Liu Yucheng;Ju Jihui;Zhang Tao;Cheng Junnan;Yang Liang;Guo Liping;Liu Yuefei(Department of Wound Repair,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China;Department of Hand Surgery,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China;Department of Foot and Ankle Surgery,Suzhou Ruihua Orthopedic Hospital,Suzhou 215104,China)

机构地区：[1]苏州瑞华骨科医院创面修复科,江苏苏州215104 [2]苏州瑞华骨科医院手外科,江苏苏州215104 [3]苏州瑞华骨科医院足踝外科,江苏苏州215104

出　　处：《足踝外科电子杂志》2023年第1期41-46,66,共7页Electronic Journal of Foot and Ankle Surgery

基　　金：苏州市姑苏卫生人才培养项目(GSWS2020116);苏州市民生科技项目关键技术应用研究(SS202092);苏州市卫生科教临床重点病种诊疗技术专项(LCZX202026);苏州市姑苏卫生人才计划项目(2020075);苏州市科教兴卫青年科技项目(KJXW2019073);苏州市企业工程技术研究中心专项(SZS2019263)。

摘　　要：目的总结分析股前外侧肌皮瓣治疗9例足踝部慢性骨髓炎的疗效及治疗体会。方法采用回顾性研究方法分析了2018年7月至2021年1月苏州瑞华骨科医院收治的符合入选标准的9例足踝部慢性骨髓炎患者,男8例,女1例;Cierny-MaderⅡA型1例、ⅡBS型1例、ⅢA型6例、ⅣA型1例,均采用股前外侧肌皮瓣治疗,并分析治疗效果。结果随访8~36个月,9例股前外侧肌皮瓣均存活,伤口均一期愈合。1例胫骨远端骨缺损较多,感染控制后6个月行髂骨植骨。慢性骨髓炎全部治愈,随访过程中无复发。根据Paley功能评定标准:优7例,良2例。大腿肌皮瓣供区遗留线性瘢痕。结论采用股前外侧肌皮瓣治疗足踝部慢性骨髓炎,能有效地控制感染、封闭无效腔、改善局部软组织血供、减少复发,是治疗足踝部慢性骨髓炎的理想方法之一。Objective To summarize the efficacy and treatment experience of anterolateral femoral muscle flap in the treatment of 9 cases of foot and ankle chronic osteomyelitis.Methods A retrospective study was used to analyze 9 patients with chronic osteomyelitis with foot and ankle who met the admission criteria from July 2018 to January 2021,including 8 males and 1 female.CiernyMaderⅡ1 case of type A,1 case of typeⅡBS,6 cases of typeⅢA,and 1 case of typeⅣA were treated with anterolateral muscle flap,and the treatment effect was analyzed.Results After 8~36 months of follow-up,all 9 cases of anterolateral thigh muscle flap survived,and the wound healed in the first stage.One case had more distal tibial bone defects,and iliac bone graft was performed 6 months after infection control.All chronic osteomyelitis was cured,and there was no recurrence during follow-up.According to Paley's functional evaluation criteria:7 cases excellent,2 cases good.Linear scarring of the thigh muscle flap donor area.Conclusion The treatment of chronic osteomyelitis in the ankle by anterolateral thigh muscle flap can effectively control infection,seal the ineffective cavity,improve local soft tissue blood supply,and reduce recurrence,which is one of the ideal methods for the treatment of chronic osteomyelitis in the foot and ankle.

关 键 词：足踝 慢性骨髓炎 肌皮瓣 清创术 

分 类 号：R683.4[医药卫生—骨科学]