小隐静脉-腓肠神经营养血管逆行岛状皮瓣修复儿童足部软组织缺损

目的 探讨小隐静脉-腓肠神经营养血管逆行岛状皮瓣在修复儿童足部软组织缺损中的应用特点.方法 2006年7月至2008年6月,应用小隐静脉一腓肠神经营养血管逆行岛状皮瓣修复儿童足背、足跟及足踝部软组织缺损8例,皮瓣切取范围6 cm×5 cm～9 cm×7 cm,除2例足踝部外,6例修复足背、足跟,皮瓣上界超过小腿中上1/3交界处,其中1例接近胭窝横纹.结果 8例皮瓣全部成活良好.经1-17个月的随访,皮瓣外观满意,感觉功能有部分恢复,足跟处亦未出现溃烂,供区无功能障碍,双小腿发育未见明显差异,外观稍受影响.皮瓣上界可超过小腿中上1/3交界处达胭窝横纹,皮瓣旋转点位于外踝尖后上方4～6 cm.结论 儿童小隐静脉一腓肠神经营养血管逆行岛状皮瓣存活的范围与成人相比差异不大,操作简单,对小腿发育未见明显影响.是修复足部软组织缺损的较好方法.

Reverse small saphenous vein-sural neurovascular island flap for the reconstruction of soft tissue defect on foot and ankle in children

Objective To investigate the clinical application of reversed small saphenons vein-sural neurovascular island flap for reconstruction of soft tissue defect on foot and ankle in children. Methods From July 2006 to June 2008, 8 children with soft tissue defects on foot, heel or ankle were treated with reversed small saphenous vein-sural neurovaacular island flaps. The size of flaps ranged from 6 cm x 5 cm to 9 cm x 7 cm. The upper margin of the flaps reached the upper third of cruris, with 1 case reaching the transverse line of pepliteal fossa. Results All the flaps survived. The patients were followed up for 1 ～ 17 months with good aesthetic and functional results. The growth of the two legs had no difference. The sensation of the flaps improved with no heel ulcer and no dysfunction at the donor site. The upper boundary of flaps can reach the upper third of the crofts even the reansverse line of popliteal fossa. The rotation point of the flaps located at 4-6 cm above the lateral ankle in children. Conclusions The reversed small saphenous vein-sural neurovascular island flap in children has a reliable survival area. The operation is easily performed without any obvious influence on the growth of the operated cruris. It is a good reconstructive method for soft tissue defect in foot and ankle.