带蒂比目鱼肌瓣修复前足软组织缺损
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张功林 ZHANG Gong-lin 兰州军区总医院全军骨科研究所, 甘肃 兰州 730050 Institute of Army Orthopaedics, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, Gansu, China 668zgl@163.com 
甄平 ZHEN Ping 兰州军区总医院全军骨科研究所, 甘肃 兰州 730050 Institute of Army Orthopaedics, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, Gansu, China  
陈克明 CHEN Ke-ming 兰州军区总医院全军骨科研究所, 甘肃 兰州 730050 Institute of Army Orthopaedics, Lanzhou General Hospital of Lanzhou Military Area, Lanzhou 730050, Gansu, China  
赵来绪 ZHAO Lai-xu 武山县人民医院骨科, 甘肃 武山 741300  
杨军林 YANG Jun-lin 武山县人民医院骨科, 甘肃 武山 741300  
周建华 ZHOU Jan-hua 武山县人民医院骨科, 甘肃 武山 741300  
薛钦义 XUE Qin-yi 武山县人民医院骨科, 甘肃 武山 741300  
期刊信息:《中国骨伤》2017年,第30卷,第12期,第1127-1130页
DOI:10.3969/j.issn.1003-0034.2017.12.010
基金项目:
中文摘要:

目的:探讨腓动脉为蒂逆行外侧半比目鱼肌瓣修复前足软组织缺损的临床疗效。

方法:自2005年1月至2013年1月,采用腓动脉为蒂逆行外侧半比目鱼肌瓣修复前足软组织缺损患者8例,其中男6例,女2例;年龄16~48岁,平均26.8岁。逆行外侧半比目鱼肌瓣转移至前足软组织缺损区,在肌瓣表面行Ⅰ期中厚网状游离植皮,供区直接缝合。术后观察肌瓣修复前足后成活情况。

结果:肌瓣全部成活,术后没有发生血管危象,其中1例受区术后发生轻微的表浅感染,1例发生肌瓣远端小的植皮坏死,经2周换药处理自然愈合。术后随访2.5~5.5年,平均3.5年。受区外形较好。踝关节功能按Cedell标准评定,良6例,可2例。

结论:当局部带蒂皮瓣或肌瓣应用受限时,外侧半比目鱼肌瓣修复后肌瓣成活较满意,很适宜修复前足软组织缺损。
【关键词】软组织损伤  外科皮瓣  修复外科手术
 
Repair soft-tissue defect in forefoot with reversed lateral soleus muscle flap
ABSTRACT  

Objective: To summarize clinical application results of repair soft tissue defect in forefoot with a reversed lateral soleus muscle flap on peroneal artery pedicle.

Methods: From January 2005 to January 2013,8 patients with soft-tissue defect on forefoot were underwent reconstruction with a reversed lateral soleus muscle flap on peroneal artery pedicle. There were 6 males and 2 female,aged from 16 to 48 years with an average of 26.8 years old. The reversed lateral soleus muscle flap was transposed to the forefoot defect area,then immediate coverage of the muscle flaps were performed by a meshed split-thickness free skin graft. The donor site was closed directly. The muscle flap survey was observed after the repair of the forefoot.

Results: All muscle flaps had survived completely. No clinical vascular deficiency was found on muscle flaps postoperatively. One case occurred recipient area sustained insignificant superficial infection,one patient developed distal muscle flap small skin graft necrosis,and spontaneous heal by 2 weeks' change dressing. Follow-up period was ranged form 2.5 to 5.5 years with an average of 3.5 years postoperatively. A good contour was confirmed at the recipient area. According to Cedell questionnaire,6 patients obtained good results and 2 fair.

Conclusion: When the local skin flap or muscle flap application is limited,lateral soleus muscle flap survey is satisfactory after repair and very suitable for repair of soft tissue defect of forefoot.
KEY WORDS  Soft tissue injuries  Surgical flaps  Reconstructive surgical procedure
 
引用本文,请按以下格式著录参考文献:
中文格式:张功林,甄平,陈克明,赵来绪,杨军林,周建华,薛钦义.带蒂比目鱼肌瓣修复前足软组织缺损[J].中国骨伤,2017,30(12):1127~1130
英文格式:ZHANG Gong-lin,ZHEN Ping,CHEN Ke-ming,ZHAO Lai-xu,YANG Jun-lin,ZHOU Jan-hua,XUE Qin-yi.Repair soft-tissue defect in forefoot with reversed lateral soleus muscle flap[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(12):1127~1130
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