摘要
目的探讨小腿和足踝部骨关节、肌腱及内固定物外露的创面,采用小腿后侧远端蒂筋膜皮瓣修复后的临床效果。方法1998年8月~2004年7月,小腿后侧远端蒂筋膜皮瓣局部移位修复34例小腿中下段及足踝部软组织缺损患者。男27例,女7例,年龄17~61岁。病程4h^8个月。小腿中下段软组织缺损18例,足踝部缺损11例,足跟负重区缺损5例。其中伴胫骨或跟骨慢性骨髓炎者13例,创面感染8例,骨外露3例。所取皮瓣范围6cm×4cm^15cm×12cm。供区创面直接缝合或中厚皮片加压包扎。结果术后31例筋膜皮瓣全部成活,3例部分坏死,对症处理后愈合。患者均获随访6~12个月,皮瓣质地及外观均满意,小腿及足踝部血运、功能活动均恢复正常。结论应用小腿后侧远端蒂筋膜皮瓣修复小腿和足踝部骨关节、肌腱及内固定物外露的创面,具有取材方便,操作简便,不牺牲小腿主要血管,皮瓣成活率高,术后外形美观等优点。
Objective To discuss the clinical effect of repairing soft tissue defects in cnemis,ankle and foot with calf and sural distal fasciocutaneous flaps. Methods From August 1998 to July 2004, 34 cases of soft tissue defects in cnemis, ankles and feet were repaired with calf and sural distal fasciocutaneous flaps. There were 27 males and 7 females, aging from 17 to 61 years and the disease course was 4 hours to 8 months. The locations were recta- inferior segment of cnemis in 18 cases, ankle and foot in 11 cases, weight loading region of calcar pedis in 5 cases. There were 13 cases chronic osteomyelitis in tibia or calcaneal bone, 8 cases of raw surface was infected, 3 cases of bone exposure. The sizes of the flap ranged from 6 cm × 4 cm to 15 cm× 12 cm. Results Thirty-one flaps survived except 3 cases which had partial necrosis. They were followed up from 6 months to 12 months. Both the quality and the appearance of the flaps were satisfactory. The blood supply and function of cnemis, ankle and foot returned to normal. Conclusion It is a convenient, simple and reliable method to repair soft tissue defects in cnemis, ankle and foot with calf and sural distal fasciocutaneous flaps,without sacrifice of major arteries and with high survival rate and beautiful outlook form of skin flaps.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2007年第1期34-36,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
小腿
远端蒂筋膜皮瓣
修复
软组织缺损
Cnemis Distal fasciocutaneous flaps Repair Soft tissue defects
