Puneky George A, Batchler Kathryn A, Kollapaneni Sai S, Blair James A, Davis Jana M
Department of Orthopedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA.
Medical Student, Medical College of Georgia at Augusta University, Augusta, GA.
OTA Int. 2023 Jul 11;6(4 Suppl):e235. doi: 10.1097/OI9.0000000000000235. eCollection 2023 Jul.
Soft tissue defects involving the distal lower extremity present challenging problems for orthopaedic surgeons to manage. Historically, wounds not amenable to primary closure have necessitated assistance from multidisciplinary teams using plastic surgeons to obtain adequate soft tissue coverage through rotational flap or free tissue transfer procedures. Techniques related to soft tissue rearrangement and local rotational flap coverage have advanced over the years with a growing knowledge of local anatomy and vasculature. The reverse sural flap may be performed to cover soft tissue defects within 10 cm of the foot or ankle region, negating the need for microvascular intervention. The simplistic nature of the reverse sural flap is appealing to orthopaedic surgeons as a means to provide timely patient care without additional support because it does not require microvasculature work or the need for intraoperative microscopes and has been popularized among orthopaedic trauma surgeons as a necessary tool to possess. Here, we discuss the reverse sural flap to include history, relevant anatomy, clinical indications, and a description of the technique for application.
涉及下肢远端的软组织缺损给骨科医生的治疗带来了具有挑战性的问题。从历史上看，无法进行一期缝合的伤口需要多学科团队（包括整形外科医生）的协助，通过旋转皮瓣或游离组织移植手术来获得足够的软组织覆盖。随着对局部解剖结构和血管系统的认识不断增加，多年来与软组织重新排列和局部旋转皮瓣覆盖相关的技术也有了进步。可以采用逆行腓肠神经营营皮瓣来覆盖足或踝区域10厘米范围内的软组织缺损，从而无需进行微血管干预。逆行腓肠神经营营皮瓣操作简单，对骨科医生来说，它是一种无需额外支持就能及时为患者提供治疗的手段，因为它不需要微血管手术或术中显微镜，并且已成为骨科创伤外科医生常用的必备工具。在此，我们讨论逆行腓肠神经营营皮瓣，包括其历史、相关解剖结构、临床适应症以及应用技术的描述。
