腓肠内侧动脉穿支肌瓣治疗胫骨上端创伤性慢性骨髓炎

目的 总结腓肠内侧动脉穿支岛状肌瓣移植治疗胫骨上端创伤性慢性骨髓炎临床应用结果。方法 应用腓肠内侧动脉穿支岛状肌瓣移植治疗胫骨上端创伤性慢性骨髓炎12例（男8例，女4例）。年龄20～58岁（平均32岁）。供区均选用同侧小腿。肌瓣表面行一期中厚网状游离植皮，供区直接缝合。结果 1例术后发生表浅感染，经交换敷料逐渐愈合，肌瓣和其上植皮全部成活，术后经过顺利，术后随访半年～5．5年（平均2．5年），没有发现明显的供区功能障碍。取得了较满意的效果。结论 该肌瓣以腓肠内侧动脉穿支为血供，具有血供丰富，血管解剖恒定，血管蒂长，以及肌瓣较薄的优点，带蒂移植适宜修复胫骨上端慢性骨髓炎。

The medial sural artery perforator island muscle flap to repair chronic posttraumatic osteomyelitis on upper region of the tibial

Objective To summarize clinical application of the medial sural artery perforator island muscle flap to repair chronic posttraumatic osteomyelitis on upper region of the tibial. Methods 12 patients（8 men, 4 women） with chronic posttraumatic osteomyelitis on upper region of the tibial underwent reconstruction with the medial sural artery perforator island muscle flap. They ranged in age from 20 to 58 years （mean, 32y）.The immediate coverage of the muscle flaps were performed by a meshed split-thickness skin graft. The donor site was closed directly, The donor leg was ipsilateral in all cases, Results One case sustained superficial infection postoperation and the gradual wound healed by daily wound dressings. All the muscle flaps and skin graft had survived completely without major complication. Follow-up period ranged from 0.5 - 5.5 years postoperatively （mean, 2,5y）, There was no remarkable donor site morbidity with satisfactory clinical results. Conclusion This muscle flap is nourished by the medial sural artery. Perforator. The muscle flaps seem to has highly vascularize, a constant vascular anatomy and a long vascular pedicle, The muscle flap is thin and suitable for repair chronic posttraumatic osteomyelitis on upper region of the tibial.