携隐神经内踝上穿支皮瓣移植用于胫骨远端骨折并软组织缺损修复中的效果  

The effect of transplanting the medial malleolus perforator flap with hidden nerve for repairing distal tibial fractures and soft tissue defects

作　　者：姜路 连纪文[1] 王洪江[1] 王权[1] JIANG Lu;LIAN Jiwen;WANG Hongjiang;WANG Quan(Department of Orthopaedics and Sport Medicine,Zhengzhou Seventh People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州市第七人民医院运动医学骨一科,河南郑州450000

出　　处：《中国医疗美容》2025年第1期51-54,共4页China Medical Cosmetology

摘　　要：目的探讨分析胫骨远端骨折并软组织缺损修复中采用携隐神经内踝上穿支皮瓣移植的效果。方法选取2022年4月至2024年4月郑州市第七人民医院收治的胫骨远端骨折并软组织缺损患者70例,均接受携隐神经内踝上穿支皮瓣移植治疗,观察其治疗情况。结果患者治疗后创面完全愈合时间为(20.59±4.73)d,皮瓣完全成活有68例,皮瓣成活率为97.14%,仅2例出现远端小面积坏死情况,经清创处理+游离移植皮瓣修复术处理后皮瓣恢复正常,皮瓣外形美观,质地柔软,无血管危象、感染、吻合血管内血栓形成等并发症发生;术后6个月患者皮瓣区域感觉功能评估显示,S0级0例,S1级0例,S2级1例,S3级2例,S4级73例。术后6个月患者生活质量评分较术前明显升高,差异有统计学意义(P<0.05)。结论胫骨远端骨折并软组织缺损修复中采用携隐神经内踝上穿支皮瓣移植的效果确切,并发症少,可促进皮瓣成活和感觉功能重建,提高患者生活质量。Objective To investigate the effect of the medial superior malleolar perforator flap with saphenous nerve in the repair of distal tibial fracture and soft tissue defect.Methods A total of 70 patients with distal tibial fractures and soft tissue defects treated in Zhengzhou Seventh People's Hospital from April 2022 to April 2024 were selected.All patients were treated with saphenous nerve medial malleolus perforator flap transplantation,and the treatment was observed.Results The complete healing time of the patient's wound after treatment was(20.59±4.73)days,and 68 cases had complete survival of the skin flap,with a survival rate of 97.14%.Only 2 cases showed small area necrosis at the distal end.The skin flap returned to normal after debridement and free graft repair.The skin flap was beautiful in appearance and soft in texture,and there were no complications such as vascular crisis,infection and intravascular thrombosis;Six months after surgery,the sensory function assessment of the skin flap area showed that there were 0 cases of S0 grade,0 cases of S1 grade,1 case of S2 grade,2 cases of S3 grade,and 73 cases of S4 grade.The quality of life score of patients 6 months after surgery was significantly higher than that before surgery,the difference was statistically significant(P<0.05).Conclusions The transplantation of the medial malleolus perforator flap with hidden nerve is effective in repairing distal tibial fractures with soft tissue defects,with few complications,promoting flap survival and sensory function reconstruction,and improving patients'quality of life.

关 键 词：携隐神经内踝上穿支皮瓣移植 胫骨远端骨折 软组织缺损 并发症 感觉功能 

分 类 号：R687.3[医药卫生—骨科学]