Department of Orthopedic Surgery, The Mayo Clinic, Rochester, MN 55901, USA.
J Shoulder Elbow Surg. 2011 Jul;20(5):807-12. doi: 10.1016/j.jse.2011.02.010. Epub 2011 May 19.
To report the outcome of using local pedicled anconeus flap (LPAF) to cover soft tissue defects over the posterior aspect of the elbow.
Twenty elbows in 20 patients who had chronic soft tissue defects over the posterior aspect of the elbow that were managed with the use of LPAF were included in this study. The mean soft tissue defect size averaged 4 × 3 cm (range, 2 × 3 cm to 7 × 4 cm). The mean duration of symptoms was 11 months (range, 4-96), and the mean number of debridement and attempt at closure of the wound defect before the flap was performed was 3 (range, 2-7).
Wound healing occurred in all elbows at an average 3 weeks (range, 2-5) after surgery. No flap complication either at the time of the surgery or postoperatively was recorded. At the final follow-up that averaged 17 months (range, 15-20) after surgery, there were significant improvements in the subjective elbow value (SEV) and Mayo Elbow Performance Score (MEPS) from average 70% (range, 50-80%) and 74% (range, 65-80%) to an average 95% (80-100%) and 90% (range, 85-100%), respectively (P = .001). All patients had full range of motion of the elbow, and all were satisfied with the surgery and would do it again.
The LAPF is a reliable flap that could be used to cover chronic soft tissue defect around the posterior aspect of the elbow, with expected wound healing in all patients at an average of 3 weeks after surgery.
报告使用局部带蒂肘后肌皮瓣(LPAF)覆盖肘后软组织缺损的结果。
本研究纳入 20 名患者的 20 侧肘部,这些患者的肘后存在慢性软组织缺损,采用 LPAF 治疗。软组织缺损平均大小为 4×3cm(范围,2×3cm 至 7×4cm)。症状平均持续时间为 11 个月(范围,4-96 个月),在皮瓣前进行清创和尝试闭合伤口的平均次数为 3 次(范围,2-7 次)。
所有肘部的伤口均在术后平均 3 周(范围,2-5 周)愈合。术中及术后均未记录皮瓣并发症。术后平均 17 个月(范围,15-20 个月)的最终随访中,主观肘部评分(SEV)和 Mayo 肘部功能评分(MEPS)分别从平均 70%(范围,50-80%)和 74%(范围,65-80%)显著改善至平均 95%(80-100%)和 90%(范围,85-100%)(P=0.001)。所有患者的肘部活动范围均完全恢复,所有患者均对手术满意,并愿意再次接受手术。
LAPF 是一种可靠的皮瓣,可用于覆盖肘后慢性软组织缺损,所有患者的伤口均有望在术后平均 3 周内愈合。