胫后动脉穿支皮瓣修复踝部软组织缺损

目的：探讨胫后动脉穿支皮瓣的临床应用疗效。方法采用胫后动脉穿支皮瓣以螺旋桨式旋转修复或以滑行推进的方式修复内踝软组织缺损6例，前踝软组织缺损3例，足跟后侧的软组织缺损13例。结果22例移植组织成活21例，1例皮瓣尖端坏死，经换药二期植皮后成活，成活率95.5%。术后经3～20个月随访，皮瓣外观、质地良好，痛温觉有一定的恢复。结论胫后动脉穿支皮瓣是修复内踝、前踝、足跟后侧软组织缺损的较佳方法。

Repair of soft tissues defect on ankle with flap of cutaneous branches of posterior tibial artery

Objective To explore the application of the flap of cutaneous branches of posterior tibial artery. Methods From July 2008 to October 2013, a flap with the pedicle called cutaneous branches of posterior tibial artery were used by means of pedicled propeller flaps and advancement flaps, 22 cases received the treatment, 6 cases for the defect on the part of medial malleolus, 3 cases for anterior malleolus, and 13 cases for heel. Results All the flaps which consisted of pedicled propeller flaps and advancement flaps survived completely on 21 cases and the flap with distal necrosis on 1 case, which was repaired by dressing change and second-stage skin graft. The survival rate was 95.5%and the appearance and texture of the skin were excellent. Conclusion The flap of cutaneous branches of posterior tibial artery is an safe and ideal method to repair the defect on the part of medial malleolus, anterior malleolus, and heel.