髂骨股前外侧联合组织瓣修复小腿皮肤伴跟骨跟腱缺损

目的探讨髂骨股前外联合组织瓣在修复跟骨、跟腱及大面积皮肤缺损中的临床应用及临床效果。方法以旋髂深血管及旋股外侧动脉的横、升支为血管蒂设计超大复合组织瓣，与损伤的胫后动脉远近端吻合游离移植，修复小腿下段、足跟皮肤缺损的同时修复跟骨、跟腱缺损。结果16例组织瓣全部成活，其中10例获6～24个月的随访，平均12个月。术后小腿及足有良好外形和保护性感觉。经功能锻炼均保证行走功能。结论以旋髂深血管及旋股外侧动脉的横、升支为血管蒂设计超大复合组织瓣修复小腿下段、足跟皮肤缺损的同时修复跟骨、跟腱缺损是可行的，而且手术安全性高。

Application of illiac-anterlateral-thigh-combined tissue flap on widespread leg cutaneous deficiency with calcaneous and achilles defect

Objective To investigate application and clinical result of iliac-anterolateral-thigh-com- bined tissue flap on oversize leg cutaneous deficiency with calcaneous and achilles defect. Methods Oversized compound tissue flap was designed vascularized by deep circumflex iliac vessels and lateral circumflex femoral vessels and anastomosed with impaired proximal and distal end of posterior tibial vessels to repair versize leg cutaneous deficiency with calcaneous and achilles defect. Rusults All of the 16 free compound tis- sue flaps survived. Follow-up was obtained in l0 patients, ranging from 6 months to 24 months, averaging at 12 months. Legs and feet havd good appearance and protective sensation, and had no obviously walking disturbance through functional exercise. Conclusion It is feasible to repair widespread leg cutaneous deficiency with calcaneous and achilles defect with oversized compound tissue flap. This surgery have the advantage of compared small trauma, short operation time and safety.