逆行腓肠神经营养血管皮瓣修复踝部软组织缺损

目的了解逆行腓肠神经营养血管皮瓣在足踝部软组织缺损中修复的临床效果。方法采用腓肠神经营养血管为蒂逆行岛状筋膜皮瓣修复踝部、足跟软组织缺损和或骨、肌腱外露创面共34例。皮瓣切取范围5cm×7cm～10cm×18cm，蒂长5～10cm。10例经皮下隧道转移，24例经明道转移。结果34例术后皮瓣全部成活，创面一期愈合，2例皮瓣远端部分淤血坏死，经清创换药后创面愈合。术后27例经3个月至4a随访，皮瓣外观、质地、弹性佳，踝关节功能恢复良好；皮肤感觉有所恢复，两点分辨率在9～16mm，平均13mm。结论逆行腓肠神经营养血管蒂岛状筋膜皮瓣血供确切，容易定位，手术步骤简单，不需牺牲小腿主要动脉，且皮瓣成活率高，质量好。

Reversed sural neurovascular fasciocutaneous flap for repair of soft tissue defect of ankle and foot

Objective To observe the clinical effect of reversed sural neurovascular fasciocutaneous flap for reconstruction of soft tissue defect of ankle and foot. Methods Thirty-four patients＇with soft tissue defects in the ankles and feet were repaired by using reversed sural neumvascular fasciccutaneous flap. The flap area ranged from 5 cm× 7 cm to 10 cm × 18 cm, and the length of pedicle from 5 cm to 10 cm. Ten flaps were transfered subcutaneously, while 24 cases were per cutem. Results All flaps survived in 34 cases. Only 2 patients encountered with partial necrosis of distal flap but healed after debridement and dressing. Twen- ty-seven cases were followed up for 3 to 48 months. The appearance, texture and elasticity of the flaps were excellent, function of ankle joint was good, and 2-point discrimination was 9-- 16 mm （ 13 mm on average）. Conclusion This flap has several merits for repairing soft tissue defect of ankle and foot：sufficient blood supply without sacrifice of major arteries, easy to design and dissect, high survival rate and excellent quality.