膝上外侧动脉穿支髂胫束皮瓣修复腘窝部瘢痕挛缩

目的:探讨膝上外侧动脉穿支髂胫束皮瓣治疗腘窝部瘢痕挛缩的临床疗效,为腘窝区瘢痕挛缩寻找最佳的手术方式。方法:自2009年1月至2011年12月,应用膝上外侧动脉穿支髂胫束动脉皮瓣修复腘窝瘢痕挛缩11例,男7例,女4例;年龄24～58岁,平均33岁;病程3个月～1年,平均6.5个月;右膝关节8例,左膝关节3例;交通伤5例,热压伤3例,烧伤3例。采用膝上外侧动脉穿支髂胫束皮瓣局部转移修复创面,切取皮瓣面积最大20.0cm×8.0cm,最小7.0cm×4.0cm。结果:术后皮瓣全部成活,3例远端血运差,局部色素沉着,表皮坏死脱痂。术后随访5个月～2年,膝关节活动均恢复正常,皮瓣外形良好,皮肤松紧度适中。结论:膝上外侧动脉穿支髂胫束皮瓣实用性好,手术操作简单,是修复腘窝区瘢痕挛缩是较为理想的皮瓣选择。

The lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contraction of popliteal fossa

Objective:To discuss clinical results of the lateral superior genicular artery perforator iliotibial band flap for the treatment of scar contracture of popliteal fossa. Methods:Form January 1999 to December 2011,11 patients with scar contraction of popliteal fossa were treated with the lateral superior genicular artery perforator iliotibial band flap. Among the patients,7 patients were male and 4 patients were female,ranging in age from 24 to 58 years old,with an average of 33 years old. The operation time ranged from 3 months to 1 year after trauma. Eight patients had injuries in the right side and 3 patients had the injuries in the left. Five patients had the injuries caused by traffic,3 patients had the injuries caused by hot compression and other 3 patients suffered from burns. The flap area ranged from 7.0 cm×4.0 cm to 20.0 cm×8.0 cm. Results:All the flaps survived. Three patients had epidermis necrosis. After 5 months to 2 years follow-up period,the knee function recovered,the flap shape was favorable and the skin firmness was moderated. Conclusion:The lateral superior genicular artery perforator iliotibial band flap is a practical,simple and an ideal donor in the reconstruction of popliteal fossa scar contracture.