游离腓骨瓣嵌合腓动脉穿支皮瓣修复跖骨缺损并重建前足及足弓  

Free fibula flap chimeric with peroneal flap for the repair of metatarsal deffect and the reconstruction of forefoot and arch

作　　者：陈达 周明武[2] CHEN Da;ZHOU Mingwu(Department of Joint Surgery,Nanyang Central Hospital,Nanyang,Henan,474500,China)

机构地区：[1]南阳市中心医院关节外科运动医学一病区,河南南阳474500 [2]中国人民解放军联勤保障部队第988医院全军创伤骨科中心,河南郑州450042

出　　处：《实用手外科杂志》2024年第3期329-333,共5页Journal of Practical Hand Surgery

摘　　要：目的探讨游离腓骨瓣嵌合腓动脉穿支皮瓣修复跖骨缺损并重建前足及足弓的临床效果。方法回顾性分析2012年8月-2022年8月收治的12例前足单一跖骨或多发跖骨伴周围皮肤软组织缺损患者的临床资料,从健侧截取腓骨瓣嵌合腓动脉穿支皮瓣,对腓骨瓣修整或折叠后固定缺损处,断端间隙填充骨诱导修复材料,修复重建前足及足弓。术后随访12~24个月,平均18个月。结果术后12例皮瓣均成活,皮瓣外观良好,色泽红润,质地柔软,无臃肿,皮瓣两点辨别觉均值7.4 mm。11例伤口一期愈合,1例延迟愈合;腓骨瓣在3~6个月内获得骨性愈合,骨性愈合时间平均为4.3个月。末次随访患肢功能根据Enneking评分系统评价为21~30分,平均27.4分。结论采用游离腓骨瓣嵌合腓动脉穿支皮瓣修复前足跖骨伴皮肤软组织损伤,重建前足及足弓,可达到修复与重建前足形态与功能的目的,临床疗效满意。Objective To investigate the clinical effect of free fibula flap with peroneal perforator flap in repairing metatarsal defect and rebuilding forefoot and arch.Methods A retrospective analysis of our hospital during August 2012 to August 2022 was 12 cases of single foot metatarsus or multiple metatarsal with the surrounding skin soft tissue defect.The patients were treated by transplatation of the contralateral fibula flap chimeric peroneal artery perforators flap,the fibula flap repaired or fixed defect after folding,the bone fracture gap was filled by bone induced repair materials,repaired and reconstructed arch and forefeet.Postoperative follow-up ranged from 12 to 24 months,with an average of 18 months.Results All the flaps survived with good appearance,rosy color,soft texture and no bloat.11 cases obtainedⅠwound healing,1 case obtained delayed union;Fibula flap had bone healing in 3 to 6 months,and bone healing averaged for 4.3 months.At the last follow-up,the Enneking score of limb function was 21~30,with an average score of 27.4.Conclusion Using free fibula flap and peroneal artery perforator flap to repair metatarsal bone with skin and soft tissue injury of forefoot and reconstruct forefoot and arch can basically achieve the purpose of repairing and rebuilding the shape and function of forefoot,and the clinical effect is satisfactory.

关 键 词：前足 骨缺损 足弓 

分 类 号：R658.3[医药卫生—外科学]