远端蒂小腿皮神经营养血管肌皮瓣移植治疗下肢创伤性慢性骨髓炎25例

为探讨小腿皮神经营养血管肌皮瓣治疗下肢创伤性慢性骨髓炎的临床效果，选择2002-01/2008-06在北京积水潭医院烧伤整形科患者25例,经彻底清创后，应用小腿皮神经营养血管肌皮瓣移植治疗小腿及足部创伤性慢性骨髓炎，其中隐神经营养血管肌皮瓣移植6例，腓肠神经营养血管肌皮瓣移植19例，皮瓣面积5 cm×3 cm~18 cm×12 cm，肌瓣面积3 cm×3 cm~8 cm×5 cm，血管蒂长5~12 cm不等。移植肌皮瓣 25 例全部成活。随访6~24个月，肌皮瓣外形、质地良好，骨髓炎未见复发。提示小腿皮神经营养血管肌皮瓣血供可靠，临床应用效果满意，是一种修复下肢创伤性慢性骨髓炎较好的方法。

Distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg for traumatic chronic osteomyelitis of lower limbs in 25 cases

To investigate the clinical efficacy of distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg for the treatment of traumatic chronic osteomyelitis of lower leg. A total of 25 patients with traumatic chronic osteomyelitis of lower legs were from Department of Burn and Plastic Surgery, Beijing Jishuitan Hospital from January 2002 to June 2008. All the patients were treated with distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg after thoroughly debridement. Among them, 6 patients were treated with myocutaneous flap with nutrient vessel of saphenous nerve, and 19 patients were treated with myocutaneous flap with nutrient vessel of sural nerve. The sizes of the flaps were 5 cm×3 cm-18 cm× 12 cm, with attached muscles were 3 cm×3 cm-8 cm×5 cm. The lengths of the pedicles were 5-12 cm. All transplanted myocutaneous flaps survived well. A 6-24 months follow-up of all patients was obtained. The shape and texture of the myocutaneous flaps were good. And there was no recurrence of osteomyelitis. Results suggested that the distally based myocutaneous flap pedicled with nutrient vessel of cutaneous nerve of leg had reliable blood supply and satisfied efficacy, which was a good method for repairing traumatic chronic osteomyelitis of lower leg.