腓动脉穿支蒂螺旋桨皮瓣修复跟骨骨折术后L形感染创面17例

摘要

目的 探讨腓动脉穿支L形皮瓣治疗跟骨骨折术后外侧L形切口愈合不良的临床疗效及应用.方法 2013年10月至2015年3月,采用一期扩创、载抗生素硫酸钙人工骨填充、腓动脉穿支蒂L形皮瓣修复治疗跟骨骨折术后外侧L形切口愈合不良患者17例.皮瓣面积8cm×2cm～11 cm ×3 cm,供区均直接缝合.结果 17例患者均获随访,时间6～18个月,平均11.5个月,所有患者感染有效治愈,皮瓣成活良好,弹性好,无瘢痕挛缩,外观满意,足踝关节活动正常.结论 腓动脉穿支蒂L形皮瓣在治疗跟骨骨折术后外侧L形切口愈合不良的应用中,因形制宜,贴合切口,针对性强,疗效优良,具有较大的推广价值.%Objective To summarize and explore the clinical effect and application of L-shaped flap pedicled with peroneal artery perforator in the treatment of unhealed lateral L-shaped incision after calcaneal fractures.Methods From October 2013 to March 2015,17 patients with unhealed L-shaped incision after calcaneal fractures were treated with one-stage thorough debridement,artificial bone filling with antibiotics-laden calcium sulphate and L-shaped flap pedicled with peroneal artery.Flap areas ranged from 8 cm × 2 cm to 11 cm × 3 cm.Donor sites are primarily sutured.Results All 17 patients were followed up for 6 to 18 months with an average of 11.5 months.All patients with infection were cured effectively,demonstrating well survived flaps with normal elasticity and pigmentation,no scar contracture,satisfactory appearance and normal ankle joint motility.Conclusions L-shaped flap pedicled with peroneal artery perforator was an effective method in the treatment of unhealed lateral L-shaped incision after calcaneal fractures.It was suitable for coverage of the unhealed wound and worthy of being popularized.