带腓血管蒂的小腿外侧复合瓣逆行修复前足外侧缺损

目的 前足外侧缺损,足部三柱桁架动态支撑结构破坏,造成内侧纵弓过度承担负重,对足的负重功能造成重大影响,研究解决前足外侧缺损的修复与重建,旨在恢复前足外侧生理支撑结构.方法 从1989年3月至2008年6月,对前足外侧缺损采用带腓血管蒂的小腿外侧复合瓣逆行转位移植修复并重建前足的外侧支撑点38例.结果 术后38例皮瓣全部成活,所有病例术后均随访6个月～10年,平均23.5个月.足的功能按美国足踝外科协会的评分标准:85分以上8例,75～85分23例,60～75分7例.结论 采用带腓血管蒂的小腿外侧复合瓣修复前足外侧缺损是一种有效的方法.

Distal pedical fibular osteoseptocutaneous flap transfer for the lateral forefoot defect

Objective The anterior-lateral defect of foot that lost one of the three supporting point of foot can lead to collapse of the lateral longitudinal arch, overload of the first metatarsal heads, and painful callus formation. It is meaningful to investigate the effect of reconstructing the lateral forefoot defect with pedical fibular osteoseptocutaneous flap. Methods From March 1989 to June 2008, there were 38 patients with anterior-lateral defect of foot were constructed. The supporting point with the local distal based pedical fibular osteoseptocutaneous flap was constracted. Results All the 38 flaps survived. All 38 patients had been followed up from 6 months to 10 years (mean 23.5 months) postoperatively. The constructed supporting point of the foot was functional. The patients could walk freely with no pain, and was satisfied with the operation. Assessed with the rating system for foot and ankle established by the American Orthopaedic Foot And Anke Society, 8 patients got a score above 85, 23 patients between 75 to 85, 7 patients between 60 to 75. Conclusion It is effective that transferring local distal based pedical fibular osteoseptocutaneous flap to repair the anterior-lateral defect of foot.