Plastic Surgery Unit, Department of Surgery, Fayoum Faculty of Medicine, Fayoum University, Fayoum, Egypt.
J Plast Reconstr Aesthet Surg. 2011 May;64(5):663-70. doi: 10.1016/j.bjps.2010.08.045. Epub 2010 Oct 12.
In April 2003, the author presented the use of the common peroneal tendon sheath as a vascularised fascial flap serving to cover exposed Achilles tendons in four patients. This flap was referred to as the peroneal tendofascial flap. The gross anatomy and blood supply of the tendon sheaths in the extensor compartment of the leg were studied in 15 below-knee amputation specimens. The tendon sheath was found to possess two distinct layers: an inner one that harbours the synovial sheath and belongs to each tendon separately, and a common outer layer ensheathing all the tendons within the extensor compartment. The outer layer was mainly nourished via five septal perforators anastomosing with each other. These anastomoses result in forming longitudinal sizeable vessels along the septum. The dissection of this newly described layer resulted in a proximally based axial fascial flap in four cases. The flaps with overlying split-thickness skin grafts (STSGs) were used successfully to cover soft-tissue defects overlying the tibia and pretibial area. Follow-up for at least 6 months proved the durability and sufficient coverage of the ankle extensor-tendon-sheath flap.
2003 年 4 月，作者介绍了使用腓骨肌腱鞘作为带血管筋膜瓣来覆盖 4 例暴露的跟腱。这种皮瓣被称为腓肠肌腱筋膜皮瓣。在 15 例膝下截肢标本中研究了小腿伸肌间隔内肌腱鞘的大体解剖和血供。肌腱鞘被发现具有两个明显的层次：一个内层容纳滑膜鞘，分别属于每个肌腱，一个共同的外层包裹伸肌间隔内的所有肌腱。外层主要通过五个相互吻合的隔穿孔得到滋养。这些吻合形成了沿着隔的纵向大血管。对这个新描述的层进行解剖，在 4 例中产生了一个以近端为基础的轴向筋膜瓣。带覆盖的断层皮片（STSG）的皮瓣成功地用于覆盖胫骨和胫前区域的软组织缺损。至少 6 个月的随访证明了踝关节伸肌腱-鞘皮瓣的耐用性和足够的覆盖。
