足底内侧游离皮瓣、肌皮瓣移植修复足跟缺损

我们采用吻合血管、神经的足底内侧游离皮瓣、肌皮瓣移植修复足跟软组织缺损８例，皮瓣全部成活。４～６周后负重行走，经６～２４个月随访，移植皮瓣无１例出现溃疡，感觉恢复良好，两点分辨觉达２．０～３．０ｃｍ。我们强调了神经吻合的重要性，认为皮瓣的感觉恢复是防止溃疡发生、取得远期良好效果的首要条件。

Repair of heel defect with a free medial plantar flap

The results of reconstruction of plantar heel defects with a local random flap or an island medial plantar flap have in a majority of cases been satisfactory.However,in cases of extensive plantar defects,local tissue transfers are almost impossible.Since 1988,8 cases with extensive plantar defects have been treated using free medial plantar cutaneous or musculocutaneous flaps.All flaps survived.six weeks postoperatively,full weight-bearing was obtained and normal activities were resumed.No ulceration in the flaps has been noted in the follow up period between 6 and 24 months,and the two poiint discrimination was from 20 to 24 mm.The paper particularly points out the importance of nerve repair in the reconstruction,because recovery of the protective sensation is the most important factor to prevent plantar ulceration,and is the basis for good operative results.