小腿皮神经营养血管皮瓣修复足踝部软组织缺损疗效观察

目的:总结小腿皮神经营养血管皮瓣修复足踝部软组织缺损的I豳床疗效.方法:回顾分析2006年1月～2010年1月采用小腿皮神经营养血管皮瓣治疗足踝皮肤软组织缺损患者37例.分别采用腓肠神经营养血管皮瓣20例,隐神经营养血管皮瓣12例,腓浅神经营养血管筋膜瓣5例修复踝足部软组织缺损.结果:37例全部得到随访,随访2周～24个月.34例皮瓣全部成活.1例腓肠神经营养血管皮瓣设计轴线与腓肠神经营养血管偏离3 cm,导致皮瓣远端边缘坏死1 cm,1例腓肠神经营养血管皮瓣因为旋转点过低(离外踝尖4 cm),皮瓣远端边缘坏死1 cm,1例隐神经营养血管皮瓣完全坏死.典型病例皮瓣完全成活,随访半年,能正常行走,无相应并发症发生.结论:小腿皮神经营养血管皮瓣修复踝足部软组织缺损具有手术操作简单,皮瓣成活可靠,不损失肢体主要动脉,供区破坏少等优点,是修复踝足创面首选的方法.

Repair of ankle and foot soft tissue defects with leg neurocutaneous vascular flap

Objective：To research the repairing methods and their clinical effects of soft tissue defects of ankle and foot with leg neurocutaneous vascular flaps.Methods：From Jan.2006 to Jan.2010,37 cases of ankle and foot soft tissue defects were treated with three different kinds of leg neurocutaneous vascular flaps.The patients included 25 males and 12 females,with an average age of thirtythree years（ranged 13-75 years old）.Three kinds of flaps were adopted in all patients,which included sural neurovascular flaps in 20 cases,saphenous neurovascular flaps in 12 cases,distally based superficial peroneal neuroadipofascial turnover flap in 5 cases.Results：34 flaps of 37 cases were completely survived,2 cases with distal edge partially necrosis were healed after short time dressing change,1 case of saphenous neurovascular flap necrosis.All the cases were followed up from 2 weeks to 24 months,and none of them recurred.Conclusion：In order to achieve the desired results,it is important to grasp the surgical indications of various kinds of flaps and keys to operation.The neurocutaneous vascular flaps could be a satisfactory method to treat the soft tissue defects in ankle and foot.