Shen Lilin, Song Suping, Lin Cuixia, Li Wenlong, Sun Xuesheng, Zhu Tao, Li Qiang
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Jan;28(1):88-91.
To investigate the feasibility and effectiveness of free popi iteal artery cutaneous branch flap anastomosed with lateral tarsal artery and vein for the repair of wound on the foot and ankle by anatomical observation and clinical application.
Latex was poured into the blood vessels of 8 cadavers, then perforator vessel of posterolateral upper calf was dissected, and the popl iteal artery cutaneous branch flap was designed with a pedicle of 2.5 cm in length; the lateral tarsal artery of the foot was dissected, could be freed to 6 cm in length; the diameter of these vessels was measured, and the number of the accompanying veins was counted. Between March 2010 and January 2013, 13 cases of foot and ankle wounds were repaired with popliteal artery cutaneous branch flap anastomosed with lateral tarsal artery and vein. The size of flaps ranged from 6.0 cm x 4.0 cm to 7.5 cm x 5.5 cm. There were 11 males and 2 females, aged from 41 to 65 years (mean, 47.3 years). The causes of injury included traffic accident in 8 cases, crushing in 4 cases, and twist by machine in 1 case. The size of wounds, ranged from 5.0 cm x 3.5 cm to 7.0 cm x 5.0 cm. The donor sites were sutured directly.
According to anatomical observation, the popliteal artery cutaneous branch flap was designed by using the lateral popliteal artery perforator for shaft. The vessel of the pedicle perforator flaps from the popliteal artery cutaneous branch flap matched well with the lateral tarsal artery.
vascular crisis occurred in 2 flaps, which survived after symptomatic treatment; the other flaps survived, with primary healing of wound and incision at donor site. The patients were all followed up 5-18 months (mean, 11 months). The flap had normal color and good elasticity. Second stage operation was performed to make the flap thinner in 3 female patients because of bulky flaps. The remaining patients had no obvious fat flap. According to American Orthopaedic Foot and Ankle Society (AOFAS) score for evaluation of the ankle function at 6 months after operation, the results were excellent in 7 cases, good in 5 cases, and fair in 1 case, with an excellent and good rate of 92.3%.
Free popliteal artery cutaneous branch flap anastomosed with lateral tarsal artery and vein for the repair of wound on the foot and ankle is simple and effective. The donor site is hidden.
通过解剖学观察和临床应用，探讨吻合跗外侧动静脉的游离腘动脉皮支皮瓣修复足踝部创面的可行性及有效性。
对8具尸体的血管灌注乳胶，解剖小腿中上段后外侧穿支血管，设计以腘动脉皮支为蒂、蒂长2.5 cm的皮瓣；解剖足部跗外侧动脉，游离长度可达6 cm；测量血管直径，计数伴行静脉数量。2010年3月至2013年1月，采用吻合跗外侧动静脉的腘动脉皮支皮瓣修复13例足踝部创面。皮瓣大小为6.0 cm×4.0 cm至7.5 cm×5.5 cm。男11例，女2例，年龄41～65岁（平均47.3岁）。致伤原因：交通事故8例，挤压伤4例，机器绞伤1例。创面大小为5.0 cm×3.5 cm至7.0 cm×5.0 cm。供区直接缝合。
解剖学观察显示，以腘外侧动脉穿支为轴设计腘动脉皮支皮瓣，该皮瓣蒂部穿支皮瓣血管与跗外侧动脉吻合良好。
2例皮瓣发生血管危象，经对症处理后成活；其余皮瓣成活，创面及供区切口一期愈合。患者均获随访5～18个月（平均11个月）。皮瓣色泽正常，弹性良好。3例女性患者因皮瓣臃肿二期行皮瓣修薄术。其余患者皮瓣无明显臃肿。术后6个月按美国足踝外科协会（AOFAS）评分评价踝关节功能，优7例，良5例，可1例，优良率92.3%。
吻合跗外侧动静脉的游离腘动脉皮支皮瓣修复足踝部创面简便有效，供区隐蔽。
