带胫骨的胫后动脉逆行岛状皮瓣修复足部复合组织缺损  

The retrograde posterior tibial artery island flap carrying tibia to repair the foot composite tissue defect

作　　者：邱俊涛[1] 路闯[1] 袁野[1] 李辉[1] 李高辉[1] 刘冲[1] 姚刘永 QIU Juntao;LU Chuang;YUAN Ye(Department of Micro Orthopedic,The 990th Hospital of PLA,Zhumadian,Henan,463000,China)

机构地区：[1]中国人民解放军联勤保障部队第990医院骨显微外科,河南驻马店463000

出　　处：《实用手外科杂志》2024年第3期334-336,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨带胫骨的胫后动脉穿支嵌合皮瓣逆行转移修复足部复合组织缺损的临床效果。方法2013年6月-2020年3月,采用带胫骨的胫后动脉穿支嵌合皮瓣逆行转移修复足部复合组织缺损创面10例,术后对皮瓣外形满意度,痛觉、触觉、温度觉、两点分辨觉及患肢功能行AOFAS评分。结果术后10例皮瓣全部成活,供区植皮成活良好,伤口一期愈合,胫前供区外形重塑良好。8例获得1~2年的随访,2例因是外地患者失访。皮瓣具有较好的外形,伤口一期愈合,移植骨与受区骨质愈合良好,供区胫骨外形重塑良好,皮瓣无瘢痕增生,无骨髓炎发生,患者对皮瓣外形及足部功能均表示满意,术后1年皮瓣两点分辨觉平均为(10.2±2.1)mm,感觉评级为S3+,根据美国踝-足部AOFAS评分平均为90.8分。结论带胫骨的胫后动脉穿支嵌合皮瓣手术操作简单、血供可靠、供区影响小足部功能恢复好、外形满意,是修复足部复合组织缺损一种可供选择的方法。Objective To investigate the clinical effect of the retrograde transfer of the chemeric posterior tibial artery perforator flap with the tibia to repair the foot composite tissue defect.Methods From June 2014 to March 2020,10 cases of retrograde transfer ofposterior tibial artery island flap with tibia used to repair compound tissue defects in the foot were analyzed.Post-operative satisfaction with flap shape,pain,touch,temperature,two-point discrimination and function of the affected limb were scored by American AOFAS.Results All 10 flaps survived,with good donor area survival,stage I wound healing and good remodelling of the anterior tibial donor area.8 patients were followed up for 1-2 years and 2 patients were lost due to being out of town.The flap had a good shape,the wound healed in stagel,the graft healed well with the recipient bone,and the donor tibia remodelled well.There was no scarring of the flap or osteomyelitis.The patient was satisfied with the shape of the flap and the function of the foot.The average two-point discrimination ofthe flap was(10.2+2.1)mm 1 year after surgery,the sensoryrating was S3+and the average American Ankle-Foot AOFAS score was 90.8 points.Conclusion The chimeric posterior tibial artery perforator flap with tibia is a better method for repairing composite tissue defects of the foot with the simple operation,the reliable blood supply,the low impact of the donor area on the functional recovery ofthe foot and the satisfactory shape.

关 键 词：外科皮瓣 穿支嵌合皮瓣 复合组织修复 胫后动脉 

分 类 号：R622[医药卫生—整形外科]