Cui Yidong, Cai Jinfang, Liu Lifeng, Cao Xuecheng, Zou Lin, Yin Hailei, Li Zongyu
Department of Orthopedics, Jinan Clinical Medical College of Second Military Medical University, Jinan Shandong 250031, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 May;24(5):562-5.
To investigate the operative procedures and clinical outcomes of the modified superficial peroneal neuro-fasciocutaneous flap in repairing soft tissue defect of forefoot.
From May 2006 to May 2009, 5 male patients (aged 40-63 years) with soft tissue defect of forefoot were treated with the modified superficial peroneal neuro-fasciocutaneous flap. Tendons and bones were exposed in all cases. Defect was caused by object crash (4 cases) and traffic accident (1 case). The sizes of soft tissue defects of forefoot were 4 cm x 2 cm-8 cm x 4 cm. Rotating point of the modified superficial peroneal neuro-fasciocutaneous flap pedicled with the peripheral vessels network of ankle joint was at the level of tibiotalar joint. The flaps ranging from 5 cm x 4 cm to 10 cm x 6 cm were adopted to repair soft tissue defects of forefoot. The donor sites were either sutured directly or covered with intermediate split thickness skin grafts.
All flaps survived and all wounds healed by first intention. Skin graft at donor site survived completely in all cases. All patients were followed up 6-18 months (mean 11 months). The appearance, texture, and function of the flap were satisfactory. There was a protective sensibility in all flaps without abrasion or ulceration, and the two-point discrimination of the flaps was 10-13 mm. The walking pattern was normal. No obvious discomfort was observed at the skin-graft donor sites.
With reliable blood supply, no sacrifice of vascular trunks, favorable texture, and thickness, the modified superficial peroneal neuro-fasciocutaneous flap pedicled with the peripheral vessels network of ankle joint is useful to repair skin soft tissue defect of the forefoot.
探讨改良腓浅神经营养血管筋膜皮瓣修复前足软组织缺损的手术方法及临床效果。
2006年5月至2009年5月，对5例（年龄40 - 63岁）前足软组织缺损患者采用改良腓浅神经营养血管筋膜皮瓣修复。所有病例均有肌腱和骨质外露。缺损原因：重物砸伤4例，交通事故伤1例。前足软组织缺损面积为4 cm×2 cm - 8 cm×4 cm。以踝关节周围血管网为蒂的改良腓浅神经营养血管筋膜皮瓣旋转点位于胫距关节水平。采用面积为5 cm×4 cm至l0 cm×6 cm的皮瓣修复前足软组织缺损。供区直接缝合或采用中厚皮片移植覆盖。
所有皮瓣均成活，创面均一期愈合。所有病例供区植皮完全成活。所有患者随访6 - 18个月（平均11个月）。皮瓣外观、质地及功能良好。所有皮瓣均有保护性感觉，无磨损及溃疡形成，两点辨别觉为10 - 13 mm。行走步态正常。供区植皮处无明显不适。
以踝关节周围血管网为蒂的改良腓浅神经营养血管筋膜皮瓣血供可靠，不牺牲主干血管，质地、厚度适宜，是修复前足皮肤软组织缺损的一种有效方法。
