逆行腓肠神经营养血管筋膜皮瓣修复足踝部软组织缺损  

REVERSED SURAL NEUROVASCULAR FASCIO-CUTANEOUS FLAP FOR RECONSTRUCTION OF SOFT-TISSUE DEFECTS IN ANKLE AND FOOT

作　　者：李军[1] 徐永清[1] 徐小山[1] 郭远发[1] 汪新民[1] 王娜[1] 

机构地区：[1]成都军区昆明总医院骨科,昆明650032

出　　处：《中国修复重建外科杂志》2004年第3期189-191,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的　研究应用逆行腓肠神经营养血管筋膜皮瓣修复足踝部软组织缺损的方法。　方法　 1994年 7月～ 2 0 0 2年 12月 ,对足踝部软组织缺损 5 2例应用逆行腓肠神经营养血管筋膜皮瓣修复 ,其中创伤致皮肤软组织缺损4 7例 ,慢性溃疡 3例 ,肿瘤切除术后 2例。切取皮瓣范围 4 cm× 6 cm～ 10 cm× 2 1cm。　结果　术后 4 8例皮瓣全部成活 ,创面 期愈合 ;4例皮瓣远端部分坏死 ,经游离植皮后创面愈合。所有软组织缺损均修复 ,骨骼、肌腱外露均覆盖。术后 4 6例皮瓣经 5个月～ 4年随访 ,平均 2 .4年 ,均有一定程度的感觉恢复 ,两点辨别觉为 11～ 17mm ,平均 14 mm ;有 4 0例皮瓣质地、弹性好 ,踝关节功能良好 ,6例皮瓣弹性较差 ,踝关节功能欠佳。　结论　逆行腓肠神经营养血管筋膜皮瓣手术设计、操作简便 ,易于切取 ,不需牺牲小腿主要动脉 ,不吻合血管 ,且皮瓣成活率高。Objective To evaluate clinical significance of reversed sural neurovascular fascio-cutaneous flap for reconstruction of soft-tissue defects in ankle and foot. Methods From July 1994 to December 2002, 52 cases of soft-tissue defects in the ankle and foot were reconstructed by use of reversed sural neurovascular fascio-cutaneous flap, including 47 cases of traumatic defects, 3 cases of chronic ulcer and 2 cases of tumors. The flap area ranged from 4 cm×6 cm to 10 cm×21 cm. Results The flaps survived in 48 cases; the distal part necrosed and secondary free-skin graft were further conducted in 4 cases. All soft-tissue defects were repaired and their accompanied bone and tendon exposure healed. Forty-six cases were followed-up for 5 months to 48 months, the color and texture of the flaps were excellent and 2-point discrimination was 11-17 mm(14 mm on average).The functions of ankle joints were good. Conclusion The reversed sural neurovascular fascio-cutaneous flap is convenient in design and dissection. Its use can retained and replace vascular anostomosed flaps to certain degrees.

关 键 词：逆行腓肠神经营养血管筋膜皮瓣 修复 足踝部 软组织缺损 

分 类 号：R628[医药卫生—整形外科] R658.3[医药卫生—外科学]