带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损

目的 :探讨带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损临床应用结果。方法 :2006年1月至2012年1月,应用带感觉神经的股前外侧带蒂皮瓣修复大粗隆部软组织缺损12例,男8例,女4例;年龄22~46岁,平均(38.1±1.6)岁。软组织缺损范围5 cm×11 cm~9 cm×16 cm。损伤后至手术时间6 h~21 d,平均(12.0±1.4)d。间隔皮穿支和肌皮穿支皮瓣分别是4例和8例。在皮瓣上部皮下组织层向髂前上棘分离出股外侧皮神经,形成带感觉神经的股前外侧带蒂皮瓣。结果:1例皮瓣发生小的皮缘裂开,术后1个月自然愈合,皮瓣全部成活。术后随访2.5~4.0年,平均(3.2±1.3)年。受区外形较好,皮瓣两点分辨觉7~13 mm,平均(9.1±1.2)mm。下肢功能用临床下肢评分(LEM)标准评定其疗效,优9例,良3例。结论:这种技术安全、可靠,很适用于修复大粗隆部软组织缺损。

Repair of the soft tissue defect in the greater trochanter of femoral with innervated anterolateral thigh pedicled skin flap

Objective:To investigate the clinical application results of repairing the soft-tissue defect in the greater trochanter with innervated anterolateral thigh pedicled flap with sensory nerve. Methods:From January 2006 to January 2012,12 patients(8 males,4 females) with soft-tissue defect in the greater trochanter underwent reconstruction with a innervated anterolateral thigh pedicled flap with sensory serve,ranging in age from 22 to 46 years old,(38.1±1.6) on average. Area of soft-tissue defect varied from from 5 cm×11 cm to 9 cm×16 cm. The operative time after injury were from 6 hours to 21 days,(12.0±1.4) on average. The septocutaneous and musculocutaneous perforator flaps were 4 and 8 cases respectively. At the upper portion of the flap,the lateral cutaneous femoral nerve was identified in subcutaneous tissue level toward the anterior superior iliac spine for innervated anterolateral thigh pedicled flap. Results:One patient was developed small wound dehiscence,which spontaneous healed at 1 month after surgery. All the flaps were survived completely. Follow-up period after operation ranged from 2.5 to 4.0 years,(3.2±1.3) on average. A good contour was confirmed on the recipient area. Two-point discrimination sensation was 7 to 13 mm with an average of (9.1±1.2). The function of the lower extremity were evaluated with LEM,the excellent results were obtained in 9 cases,good results in 3 cases. Conclusion:Satisfactory clinical results were obtained in this series. This technique is safe,reliable,and particularly useful for repairing the greater trochanter soft-tissue defect.