腓动脉穿支蒂螺旋桨皮瓣修复足踝部软组织缺损

目的 :探讨腓动脉穿支蒂螺旋桨皮瓣修复足踝部软组织缺损的临床疗效。方法:自2012年6月至2014年4月,采用腓动脉穿支蒂螺旋桨皮瓣治疗足踝部软组织缺损患者20例,其中男14例,女6例;年龄8~64岁,平均(36.2±4.6)岁;缺损面积5 cm×2 cm~22 cm×7 cm。损伤至手术时间8~90 d,平均(38.2±6.2)d。末次随访时采用美国足踝外科学会(AOFAS)踝-后足评分进行临床疗效评价。结果:20例均获随访,时间6~24个月,平均(13.5±2.2)个月。皮瓣外观及质地良好。手术时间90~210 min,平均(120±32)min。19例皮瓣全部存活,1例出现皮瓣部分坏死予再次清创植皮术后治愈。末次随访时AOFAS评分为(93.1±10.0),其中优14例,良6例。结论:腓动脉穿支蒂螺旋桨皮瓣治疗足踝部软组织缺损安全有效,临床疗效满意。

Repairing ankle and foot injuries with perforator-based propeller flaps

Objective: To evaluate clinical effects of repairing ankle and foot injuries with perforator-based propeller flaps.Methods: From June 2012 to April 2014,20 patients with soft tissue defects on the foot and ankle were treated by perforator-based propeller flaps,including 14 males and 6 females with an average age of (36.2±4.6) years old ranging from 8 to 64 years. Area of soft tissue defect varied from 5 cm×2 cm to 22 cm×7 cm. The time from injury to operation ranged from 8 to 90 days, with an average of (38.2±6.2) days. AOFAS scoring were applied to evaluate therapeutic effects.Results: All patients were followed up from 6 to 24 months with an average of (13.5±2.2) months. Appearance and quality of flap were good. Operation time was 90 to 210 min,with an average of (120±32) min. Nineteen flaps were survived successfully,the flap edge of 1 case was necrosis and healed after free skin grafting. A good contour was confirmed on the recipient area. The total AOFAS score was (93.1±10.0) at the final following-up,14 cases obtained excellent results and 6 cases were good.Conclusion: Perforator-based propeller flaps for ankle and foot injuries has advantages of safe,effectivity and could receive good results.