腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣的临床应用

目的：总结腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣修复足踝部软组织缺损的临床效果。方法：自2004年2月至2007年12月对27例各种原因造成的小腿远端及足踝部软组织缺损采用腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣进行修复。其中男21例，女6例；年龄7个月-64岁，平均31．5岁。缺损部位：外踝部7例，内踝部5例，足背部8例，足跟及足底7例。皮肤软组织缺损面积2．5cm×3．5cm-10cm×24cm，切取皮瓣面积3cm×4cm～12cm×26．5cm。结果：7例术后3—7d皮瓣轻度肿胀，7d后肿胀逐渐消退，所有皮瓣全部成活。术后随访3-12个月，平均5个月，皮瓣不臃肿，外形良好，供区功能无障碍。结论：应用腓动脉穿支供养的远端蒂腓肠神经营养血管皮瓣，具有血供丰富，血管解剖恒定，皮瓣近端可达胭窝区，逆转距离长，修复范围大，操作简单，皮瓣较薄的优点，是修复小腿远段及足踝部软组织缺损的较好方法。

The clinical application of the neurovascular island flap of the calf supported by perforating branches of peroneal artery

Objective: To study the clinical application of the neurovascular island flap of the calf supported by perforating branches of peroneal artery for the soft tissue defects of ankle and the foot. Methods: The flaps were used in 27 cases to repair the soft tissue defects of ankle and the lower leg from February 2004 to December 2007. Among them,21 cases were male and 6 cases were female,ranging in age from 7 months to 64 years,with an average of 31.5 years. There were 7 cases with external malleolus,5 cases with medial malleolus,8 cases with dorsum of foot,7 cases with achilles tendon. The range of soft tissue defects was from 2.5 cm×3.5 cm to 10 cm×24 cm and the range of flap was from 3 cm×4 cm to 12 cm×26.5 cm. Results: Seven cases were lightly swelling and distension after operation from 3 to 7 days. After 7 days,the swelling subsidised gradually and all flaps survived. In the follow-up for 3-12 months with an average of 5 months,all flaps showed fine appearance without fat and clumsy. The function of donor site was very well. Conclusion: The neurovascular island flap of the calf supported by perforating branches of peroneal artery can provide reliable blood supply,long reversed distance and wide repairing limitation and the proximal end of flap can reach to popliteal fossa. It is a good method to repair the defects of the lower leg and the foot.