Yu Li, Tan JinHai, Cai Lin, Yu GuoRong, Tao ShengXiang, Wei RenXiong, Chen ZhenGuang
From the Department of Orthopedics, Zhongnan Hospital, Wuhan University, China.
Ann Plast Surg. 2012 Jan;68(1):83-7. doi: 10.1097/SAP.0b013e3181fe9351.
This article reports 2 cross-leg free composite tissue flaps for repairing the severe composite tissue defects in lower leg without suitable adjacent recipient vasculature for microvascular anastomosis. The osseous myocutaneous flap of ilium and tensor fascia lata pedicled with ascending branch of lateral femoral circumflex vessels and the osseous muscle flap of scapula and latissimus dorsi pedicled with subscapular vessels were performed, respectively, to reconstruct the bone and soft-tissue defects in the lower leg of 2 patients. Both donor vessels were the posterior tibial artery and great saphenous vein from the contralateral lower leg. The legs and the bone flaps were immobilized by an external fixator. The periods of pedicle division were 43 and 67 days, respectively, after transplantation. Both flaps survived after pedicle division and the patients regained the ability to walk. There were no such complications as joint stiffness or donor site morbidity except for a linear scar. The 2 cross-leg free composite tissue flaps were optional methods for salvaging limbs that were otherwise nonreconstructable. But the indication for cross-leg free-tissue flap should be limited strictly.
本文报道了2例用于修复小腿严重复合组织缺损的交叉腿游离复合组织瓣，该小腿无合适的相邻受区血管进行微血管吻合。分别采用以旋股外侧血管升支为蒂的髂骨骨皮瓣和阔筋膜张肌瓣，以及以肩胛下血管为蒂的肩胛骨和背阔肌骨肌瓣，修复2例患者小腿的骨和软组织缺损。供区血管均为对侧小腿的胫后动脉和大隐静脉。腿部和骨瓣用外固定器固定。移植后断蒂时间分别为43天和67天。断蒂后两皮瓣均存活，患者恢复行走能力。除线性瘢痕外，无关节僵硬或供区并发症等情况。这2例交叉腿游离复合组织瓣是挽救原本无法重建肢体的可选方法。但交叉腿游离组织瓣的适应证应严格限制。
