目的 探讨以胫后动脉双穿支为蒂的V-Y推进皮瓣修复跟腱区小面积软组织缺损的临床疗效.方法 2014年6月至2017年6月,采用胫后动脉双穿支为蒂的V-Y推进皮瓣修复跟腱区较小创面共8例,创面面积为1.5 cm×3.5 cm～3.5 cm×5.0 cm,皮瓣切取面积为2.0 cm×8.0 cm～4.0 cm×12.0 cm.供区创面直接拉拢缝合.8例患者均获得随访,术后随访内容有皮瓣外形、质地、色泽、弹性、臃肿度等.结果 8例双穿支为蒂的V-Y推进皮瓣全部成活,皮瓣供区一期缝合.术后随访3～12个月,皮瓣外形、质地好,色泽、弹性好,无局部皮肤隆起,皮瓣几乎与周围组织相平.根据美国骨科协会足踝外科分会标准评定:优6例,良2例.患者均有较高的满意度.结论 以胫后动脉双穿支为蒂的V-Y推进皮瓣,手术方法简单、安全,对皮瓣供区影响小,是修复跟腱区小面积软组织缺损较为理想的方法之一.%Objective To investigate the clinical effect of the V-Y advancement flap based on double perfo-rators of the posterior tibial artery for reconstruction of small-area tissue defect in the achilles tendon. Methods From June, 2014 to June, 2017, a total of 8 patients with small-area tissue defect in the achilles tendon were repaired by the V-Y advancement flap based on double perforators of the posterior tibial artery. The size of defects ranged from 1.5 cm ×3.5 cm to 3.5 cm ×5.0 cm, and the size of flaps ranged from 2.0 cm ×8.0 cm to 4.0 cm ×12.0 cm. The donor area was directly sutured. Eight cases were followed-up, and the appearance, quality, color and elasticity was raorded. Results All V-Y advancement flaps based on double perforators of the posterior tibial artery survived, and all donor sites were directly sutured. Followed-up for 3 to 12 months. All V-Y advancement flaps were flat with the sur-rounding tissue. The appearance, quality, color and elasticity of flaps were good. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS), the results of 8 patients were ex-cellent in 6 cases, and good in 2 cases. The patients had a high degree of satisfaction. Conclusion Application of the V-Y advancement flap based on the double perforators of the posterior tibial artery is an ideal method to repair the small-area tissue defect in the achilles tendon. This kind of surgery is simple, safe and has minimal donor site mor-bidity.
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