【摘要】 目的探讨远端蒂小隐静脉—腓肠神经营养血管肌皮瓣修复踝足部特殊病例的软组织缺损的临床效果。方法应用远端蒂小隐静脉—腓肠神经营养血管肌皮瓣修复踝足部特殊病例的软组织缺损12例,其中胫骨下段软组织缺损伴慢性骨髓炎2例,足后跟软组织缺损伴死腔6例,足底软组织缺损伴跟骨表层骨质缺失(5~8mm)4例。皮瓣切取的面积为16cm×13cm~10cm×7cm,切取的腓肠肌厚度1~4cm,肌瓣的面积比相应的皮瓣面积小。结果12例远端蒂小隐静脉—腓肠神经营养血管肌皮瓣全部成活,伤口均一期愈合。肌皮瓣外形满意,肌皮瓣和足背外侧感觉大部分恢复,行走负重良好,供区未见明显功能障碍。结论远端蒂小隐静脉—腓肠神经营养血管肌皮瓣血供可靠,容易成活,切取简便,是修复踝足部特殊病例软组织缺损的好方法。更多还原

【Abstract】 Objective To report the clinical effects of distally based small saphenous vein-sural nerve nutrition blood vessel myocutaneous flap repairing the soft tissue defect of foot and ankle in special cases. Methods Since February 2004,distally based small saphenous vein-sural nerve nutrition blood vessel myocutaneous flap was applied for repairing the soft tissue defect of foot and ankle in 12 special cases,including 2 cases of the soft tissue defect associated with chronic osteomylitis of tibia lower section,6 cases of the soft tissue defect with dead space of foot heel,and 4 cases of the soft tissue defect of sole of foot with bone loss of calcaneus epicarp (5.0～8.0mm).The scope of the flap was 16.0cm×13.0cm～10.0cm×7.0cm,the thickness of gastrocnemius flap was 1.0～4.0cm,and the myocutaneous flap was smaller than the corresponding skin flap. Results All the 12 distally based small saphenous vein-sural nerve nutrition blood vessel myocutaneous flaps survived and scored first grade.Myocutaneous flap outline was fine,and feels over myocutaneous flap and the lateral part of the foot and dorsal recovered almost.The patients could walk and load well.No obvious functional disability has been found in the flap providing area. Conclusion Distally based small saphenous vein-sural nerve nutrition blood vessel myocutaneous flap has abundant blood supply,can be cut simply and can survive essily.It is a better and curative method for repairing the soft tissue defect of foot and ankle in special cases.更多还原