腓骨肌腱鞘筋膜瓣与脂肪筋膜瓣联合转移修复足跟后深度组织缺损

目的探索一种新的局部组织瓣修复足跟后深度组织缺损的方法及效果。方法于小腿下段,外踝腓外侧筋膜间隙,设计切取腓骨肌腱鞘筋膜瓣与脂肪筋膜瓣联合转移,最大筋膜瓣6cm×13cm,覆盖跟腱及跟骨裸露缺损,在其上移植全厚皮片或中厚皮片修复。结果2004至2005年11月,修复足跟后组织缺损6例。修复最小缺损3·5cm×4·0cm,最大4cm×6cm。术后转移筋膜瓣,移植皮片完全存活。随访3个月至1年11个月,供受区稳定愈合,功能形态恢复满意。结论腓骨肌腱鞘筋膜瓣与脂肪筋膜瓣联合转移加皮片移植法,就近取材,供区损伤小,筋膜瓣薄,柔韧滑润,血运恒定丰富,手术时间短,为小腿下段足跟后难愈性中、小面积缺损提供了一种新的简便、可靠的修复方法。

Heel deep tissue defects were repaired by perneal tendofascial flap conjoined with adipofasical flap

OBJECTIVE: To explore a new method and estimate it's outcome to repair deep heel tissue injuries with local tissue flap. METHODS: At lower cnemis, a fat fascial flap combined with perneal tendofascial flap were designed and elevated between the lateral maleolars blank, the largest area is 6 cm x 13 cm, which were transplanted to cover naked calcaneal tendon and calcaneal bone, full-thickness free skin graft or middle-thickness free skin graft were grafted on flap. RESULTS: 6 patients suffered from heel tissue defects had been treated from January 2004 to November 2005. The smallest area was 3.5 cm x 4.0 cm and the largest was 4 cm x 6 cm. All fascial flaps and free skin grafts were successfully survived after operations. All patients were followed up 3-23 months, the operation areas were healed, the functions and configurations were satisfied. CONCLUSIONS: Perneal tendofascial flap conjoined with adipofasical flap and free skin graft are used to repair heel deep tissue defects, which is a handy, dependable way for repairing of the small tissue defects of the lower third of leg and heel.