横向嵌合腓骨瓣重建复杂前足毁损并多跖骨缺损  

Reconstruction of complex forefoot disfigurement with multiple metatarsal defects by transversely embedded fibula flap

作　　者：牟勇[1] 古欣庆 黄东[1] 吴伟炽[1] 朱红亮 陈宇璠 MOU Yong;GU Xinqing;HUANG Dong(Department of Microsurgery,Guangdong Second Provincial General Hospital,Guangzhou,Guangdong,510317,China)

机构地区：[1]广东省第二人民医院显微修复骨科,广东广州510317 [2]广州和平骨科医院创伤显微外三科,广东广州510300

出　　处：《实用手外科杂志》2024年第2期139-142,共4页Journal of Practical Hand Surgery

摘　　要：目的介绍一种横向嵌合腓骨瓣重建复杂前足毁损并多跖骨缺损的新方法。方法2019年8月-2023年5月,共收治前足毁损并多跖骨缺损6例,骨骼、肌腱外露,均伴有全跖骨缺损。采用腓骨瓣横向重建足部横弓与足部负重区,根据缺损程度联合股前外侧皮瓣修复足部创面。供区创面均直接缝合关闭。结果6例皮瓣均顺利成活,且均获持续随访,平均时间17个月,足部外形可,穿鞋正常,质地柔软耐磨,供区愈合良好,下肢步行功能均恢复良好,步态无明显异常。结论应用横向嵌合腓骨瓣移植重建复杂前足毁损并多跖骨缺损,可以最大限度恢复前足外形与负重耐磨功能,是一种理想的治疗方法,值得临床推广应用。Objective To introduce a new method of reconstructing complex forefoot disfigurement multimetatarsal defects by transversely embedded fibula flap.Methods From August 2019 to May 2024,6 cases of forefoot disfigurement multimetatarsal defects were admitted,with bones and tendons exposed,all of which were accompanied by total metatarsal defects.Fibula flap was used to reconstruct the transverse arch and weight-bearing area of the foot,and the anterolateral femoral flap was used to repair the foot trauma according to the degree of defect.The donor area was closed with direct sutures.Results The flaps of the 6 cases were successfully survived and were followed up for an average of 17 months,with normal foot shape,normal shoe wear,soft and wear-resistant texture,good healing of the donor area,and good recovery of the walking function of the lower limbs,with no obvious abnormality in the gait.Conclusion The application of transverse embedded fibula flap to reconstruct complex forefoot disfigurement with multiple metatarsal defects can maximize the restoration of forefoot shape and weight-bearing wear-resistant function,and make full use of the advantages of fibula flap donor area,with less damage to the donor area,which is an ideal new method of repairing forefoot disfigurement with multiple metatarsal defects,and it is worth to be popularized in the clinic.

关 键 词：前足毁损 跖骨缺损 腓骨瓣 横弓 

分 类 号：R68[医药卫生—骨科学]