膝上外侧动脉骨皮瓣游离移植修复肢体复合组织缺损

目的探讨膝上外侧动脉骨皮瓣游离移植修复肢体复合组织缺损的l晦床效果。方法以大腿外侧正中为轴心线，股骨外上髁上约4cm处为中心，在髌骨外侧缘向近端延长线、股二头肌后缘、髌骨上缘区域内，根据受区需要设计和切取膝上外侧动脉为蒂的骨皮瓣。选择与受区动脉顺行或逆行端侧或端端吻合。修复前臂、手、小腿、足部外伤后骨缺损、局限性骨髓炎并软组织缺损15例，骨瓣面积7．2cm×4cm～3cm×1cm；皮瓣面积12cm×6cm～3cm×3cm。结果15例游离移植骨皮瓣均成活，创面未再发感染，3—4个月骨瓣与受区骨骼愈合。修复后伤肢外观满意。结论膝上外侧动脉骨皮瓣游离移植是修复肢体复合组织缺损的理想方法之一。

The transplantation of free nsteocutaneonsflap pedicle with the lateral superior genicular artery to reconstruct the bone and soft tissue defect on the limb

Objective To observe the result of free osteocutaneous - flap vascularized on the lateral superior geniculax artery transplantation to reconstruct the bone and soft tissue defect of the limb. Methods To design the cutaneous flap around the key point which was the cutaneous branch of the lateral superior genicular artery perforating the subcutaneous located at the middle line on the lateral surface of distal thigh and 4 cm proximal to the lateral superior condylar of femur. 15 cases with bone and soft tissue defect on the forearm, hand and lower limb were repaired by transplantation of this osteocutaneousflap with one stage, the area of the cutaneous flap was between 12 cm × 6 cm - 3 cm× 3 cm and the area of bone flap was 7. 2 cm ×4 cm ～ 3 cm×1 cm. Results All the osteocutaneous flap were survived and bone flap was union with the recipient bone 3 - 4 months after the operation, the surface of the repaired limb was satisfactory. Conclusion The transplantation of free osleocutaneousflap pediele with the lateral superior geniculax artery is one of the best method to reconstruct the bone and soft tissue defect on the limb.