低旋转点隐神经营养血管皮瓣修复足踝部软组织缺损的临床应用  

Clinical application of low rotation point sural neurocutaneous vascular flap for repairing soft tissue defect of foot and ankle

作　　者：郑啸 张凯红 袁光华 邓焰峰 邓创伟 柳昊 ZHENG Xiao;ZHANG Kai-hong;YUAN Guang-hua;DENG Yan-feng;DENG Chuang-wei;LIU Hao(Department of Orthopedics,Wuhan Xinzhou District People's Hospital,Wuhan Hubei 430400,China;Department of Orthopedics,Central Hospital of Wuhan Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan Hubei 430000,China)

机构地区：[1]武汉市新洲区人民医院骨科,湖北武汉430400 [2]华中科技大学同济医学院附属武汉市中心医院骨科,湖北武汉430000

出　　处：《局解手术学杂志》2023年第9期800-804,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：湖北省卫生健康委联合青年项目-重点基金项目(WJ2019H348);武汉市卫生健康科研基金资助(WX19Q01);武汉市卫健委科研项目(WX19D21)。

摘　　要：目的探讨低旋转点隐神经营养血管皮瓣修复足踝部软组织缺损的方法和临床效果。方法选择武汉市新洲区人民医院足踝部软组织缺损的患者43例,均行低旋转点隐神经营养血管皮瓣修复,皮瓣切取面积为9.2 cm×6.5 cm~12.5 cm×8.4 cm。观察术后皮瓣成活及切口愈合情况。术后1个月,采用美国足踝外科协会(AOFAS)评分评估足部功能恢复情况;术后3个月采用自制的满意度调查问卷对患者展开满意度调查。术后随访3~12个月,评价手术治疗效果。结果患者皮瓣均全部成活,切口Ⅰ期愈合;随访期间,所有皮瓣外观不臃肿,无明显挛缩,可塑性好,皮肤柔软,皮瓣色泽、薄厚与受区基本接近。术后1个月患者AOFAS评分平均82.52分,优良率为90.70%;皮瓣及供区无溃疡复发、创面感染等并发症,患者行走及负重功能基本恢复。术后3个月患者外观总满意度为93.02%。结论低旋转点隐神经营养血管皮瓣具有不牺牲主干血管、蒂长、转移灵活的特点,其旋转点较传统隐神经营养血管皮瓣更低,是修复足背远端和跟部软组织缺损的理想供区。Objective To investigate the surgical method and clinical outcome of low rotation point sural neurocutaneous vascular flap for repairing soft tissue defect of foot and ankle.Methods A total of 43 patients with soft tissue defect of foot and ankle were selected from Wuhan Xinzhou District People's Hospital,and they were all repaired by low rotation point sural neurocutaneous vascular flap,with the incision area of the flap from 9.2 cm×6.5 cm to 12.5 cm×8.4 cm.The survival of flap and wound healing after surgery were observed.The functional recovery of the foot was evaluated by the American Orthopaedic Foot and Ankle Society(AOFAS)score 1 month after surgery,and a self-designed questionnaire of satisfaction was used to investigate the satisfaction of patients 3 months after surgery.The follow-up was 3~12 months,then the effect of surgical treatment was evaluated.Results All flaps survived and the incision healed in the stageⅠ.During the follow up,all the flaps were without bloated appearance or obvious contracture,with good plasticity and soft skin,and the color and thickness of the flaps were basically close to those of the recipient area.The average AOFAS score of patients 1 month after surgery was 82.52 points,with an excellent rate of 90.70%.There was no ulcer recurrence,wound infection or other complications in the flap and the donor area,and the walking and weight bearing functions of patients were basically recovered.The total appearance satisfaction of patients was 93.02%3 months after surgery.Conclusion The low rotation point sural neurocutaneous vascular flap has the characteristics of not sacrificing the main blood vessels,long pedicle,flexible transposition,and its rotation point is lower than that of the traditional sural neuro⁃cutaneous vascular flap,which is an ideal donor area for repairing the soft tissue defects in the distal dorsum of foot and heel.

关 键 词：低旋转点 隐神经营养血管皮瓣 足踝部软组织缺损 皮瓣修复 

分 类 号：R683.42[医药卫生—骨科学]