中国修复重建外科杂志

中国修复重建外科杂志

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“网球拍”状内踝上穿支螺旋桨皮瓣修复跟踝部软组织缺损疗效观察

程定 , 崔树英 , 张成书 , 李艳玲 , 李恒 , 王香玲 , 王俊 , 郑乐

平煤神马医疗集团总医院烧伤整形科（河南省平顶山 467000）

收稿日期: 2018-04-10;  修回日期:2018-10-10; 

通讯作者: 崔树英, Email: yuxiangchengding@126.com

Effectiveness of medial ankle branches propeller “Tennis racket-like” flap in repair of heel-ankle tissue defects

CHENG Ding , CUI Shuying , ZHANG Chengshu , LI Yanling , LI Heng , WANG Xiangling , WANG Jun , ZHENG Le

Department of Burns and Plastic Surgery, Pingdingshan Traditional Pingmei Shenma Medical Hospital, Pingdingshan Henan, 467000, P.R.China

Corresponding Author: CUI Shuying, Email: yuxiangchengding@126.com

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目的 总结“网球拍”状内踝上穿支螺旋桨皮瓣修复跟踝部软组织缺损的疗效。 方法 2011 年 6 月—2016 年 6 月，收治 50 例跟踝部软组织缺损患者。男 40 例，女 10 例；年龄 6～58 岁，中位年龄为 35.6 岁。缺损原因：外伤 44 例，外伤后瘢痕畸形 2 例，慢性溃疡 2 例，鳞癌 2 例。缺损部位：足跟部 20 例，踝部 15 例，跟踝部 15 例。软组织缺损范围为 3.5 cm×2.0 cm～13.0 cm×10.0 cm。病程 3 h～2 个月，平均 28 d。采用“网球拍”状内踝上穿支螺旋桨皮瓣修复，皮瓣切取范围 3.8 cm×2.2 cm～13.4 cm×10.3 cm。供区直接缝合（5 例）或植皮修复（45 例）。 结果 术后皮瓣均顺利成活，创面Ⅰ期愈合。供区 1 例植皮部分坏死，经换药后愈合；其余植皮均顺利成活，切口均Ⅰ期愈合。术后 48 例获随访 12 个月，皮瓣修复处外形、功能恢复良好，感觉恢复良好。 结论 “网球拍”状内踝上穿支螺旋桨皮瓣成活率高，血供可靠，移位后能恢复感觉，是修复跟踝部缺损较理想的方式之一。

Objective To investigate effectiveness of the medial ankle branches propeller " Tennis racket-like” flap in repair of heel-ankle tissue defect. Methods Between June 2011 and June 2016, 50 patients with heel-ankle tissue defects were treated. There were 40 males and 10 females, with a median age of 35.6 years (range, 6–58 years). The defects were caused by trauma in 44 cases, scar deformity after trauma in 2 cases, chronic ulcer in 2 cases, and squamous cell carcinoma in 2 cases. The defects located at heel in 20 cases, ankle in 15 cases, and heel-ankle in 15 cases. The size of heel-ankle tissue defect ranged from 3.5 cm×2.0 cm to 13.0×10.0 cm. The course of disease ranged from 3 hours to 2 months (mean, 28 days). All wounds were repaired by the medial ankle branches propeller " Tennis racket-like” flap in a size of 3.8 cm×2.2 cm–13.4 cm×10.3 cm. The donor site was directly sutured in 5 cases or repaired by skin grafting in 45 cases. Results All flaps survived and wounds healed by first intention. Partial necrosis of skin grafting occurred in 1 case, and the wound recovered by change dressing. The other skin grafting survived and wounds healed by first intention. Forty-eight patients were followed up 12 months after operation. The appearance, sensory, and function of repaired heel-ankle flaps were satisfactory. Conclusion For heel-ankle tissue defect repair, the medial ankle branches propeller " Tennis racket-like” flap has advantages of the high survival rate, reliable blood supply, and sensory recovery.

关键词: 内踝上穿支皮瓣; 螺旋桨皮瓣; 跟踝部缺损

Key words: Medial ankle branches flap; propeller flap; heel-ankle tissue defect

引用本文： 程定, 崔树英, 张成书, 李艳玲, 李恒, 王香玲, 王俊, 郑乐. “网球拍”状内踝上穿支螺旋桨皮瓣修复跟踝部软组织缺损疗效观察. 中国修复重建外科杂志, 2018, 32(11): 1450-1453. doi: 10.7507/1002-1892.201804030 复制

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