携带跖肌腱腓肠神经营养血管皮瓣修复足部复合组织缺损

摘要

目的 探讨携带跖肌腱腓肠神经营养血管皮瓣修复足部复合组织缺损的临床疗效.方法 应用携带跖肌腱腓肠神经营养血管皮瓣修复12例足部复合组织缺损患者,创面缺损面积7 cm×4 cm~10 cm×7 cm,肌腱缺损长度2~6 cm,切取皮瓣面积:9 cm×6 cm~12 cm×9 cm,切取跖肌腱长度4~12 cm.结果 患者均获得随访,时间6~18个月.12例皮瓣全部成活,1例皮瓣臃肿,二期行皮瓣削薄术;其余皮瓣外形无明显臃肿,质地良好.皮瓣感觉恢复达S3+ 3例,S3 7例,S2 2例.AOFAS踝-后足功能评分:优6例,良6例.结论 携带跖肌腱腓肠神经营养血管皮瓣切取简单方便、血供可靠,可一期修复足部肌腱、皮肤复合组织缺损,足部功能恢复良好.%Objective To investigate the clinical effect of sural neurovascular flap with plantaris tendon for complex tissue defect of foot.Methods Sural neurovascular flaps with plantaris tendon were used to repair 12 cases of complex tissue defect of foot.The defect area was 7 cm×4 cm~10 cm×7 cm,length of tendon defect was 2~6 cm,flaps area was 9 cm×6 cm~12 cm×9 cm,length of plantaris tendon was 4~12 cm.Results All cases were followed up for 6~18 months.12 flaps survived completely,1 case showed bloated and was reshaped,the other flaps showed good texture matches and contour.The sensation of the flaps returned to S3+ 3 cases,S3 7 cases,S2 2 cases.According to the standard of the AOFAS,the results were excellent in 6 cases,good in 6 cases.Conclusions Sural neurovascular flap with plantaris tendon have the advantages of simple operation,abundant blood supply,which can repair tendon and skin tissue defect of the foot at once,the function of the foot get well.