Mahmood Farrukh, Mehrose Muhammad Younas, Tasneem Shehzadi, Mahmood Nasir, Raza Ahmad
The Children Hospital and Institute of the Child Health Lahore, Pakistan.
J Ayub Med Coll Abbottabad. 2011 Oct-Dec;23(4):40-2.
Wheel spoke injury of the ankle and foot is very common in children and its reconstruction is challenging. Reverse sural artery flap is very useful to cover these defects. Free tissue transfer is an option in children which needs a micro-vascular expertise, expensive equipment and long operating time.
Sixteen cases with ankle and foot defects were operated during a period of 18 months at the Children Hospital and Institute of Child Health Lahore. The efficacy of sural artery flap for the coverage of these defects was evaluated.
Sixteen children presented with defects of foot and ankle, 62.5% were male and 37.5% were female. Their age ranged from 2-13 years. All patients had trauma to the foot, most of them having wheel spoke injury. Some had roadside accidents and glass injury. Fascio-cutaneous flaps were used in 9 patients and fascia only flap in 7 patients with split thickness skin graft. Flaps were used to cover tendoachilles, malleoli, dorsum of foot, calcaneus, amputation stump and to reconstruct heel. Fifteen flaps survived whereas one necrosed. There was loss of skin graft in two cases of adipofascial flaps. Mean follow-up was 6 months.
Sural artery flap is quick and safe with wide arc of rotation and minimal donor site morbidity and it does not sacrifice major extremity vessel.
儿童踝足部轮辐伤很常见，其重建具有挑战性。逆行腓肠神经营养血管皮瓣对覆盖这些缺损非常有用。游离组织移植是儿童的一种选择，但需要微血管专业技术、昂贵的设备且手术时间长。
在拉合尔儿童医院及儿童健康研究所的18个月期间，对16例踝足部缺损患者进行了手术。评估了腓肠神经营养血管皮瓣覆盖这些缺损的疗效。
16例儿童存在足踝部缺损，男性占62.5%，女性占37.5%。年龄范围为2至13岁。所有患者足部均有外伤，大多数为轮辐伤。部分患者有路边事故及玻璃划伤。9例患者采用筋膜皮瓣，7例患者采用仅含筋膜的皮瓣并植皮。皮瓣用于覆盖跟腱、内外踝、足背、跟骨、截肢残端及重建足跟。15例皮瓣存活，1例坏死。2例脂肪筋膜皮瓣出现植皮失败。平均随访6个月。
腓肠神经营养血管皮瓣操作迅速、安全，旋转弧宽，供区并发症少，且不牺牲肢体主要血管。
