Weber R A, Pederson W C
Hand Center of San Antonio, University of Texas Health Science Center, USA.
J Reconstr Microsurg. 1995 Jul;11(4):239-41; discussion 242-4. doi: 10.1055/s-2007-1006538.
The fibular osteocutaneous free flap has become a popular choice for the reconstruction of bone and skin defects. A potential drawback has been the reported unreliability of the skin paddle. Previous studies have emphasized total loss of the overlying skin paddle, if the expected perforating vessels are not present either in the intermuscular septum or in the soleus. Two cases are presented in which the skin paddle was found to be supplied by vessels arising from the proximal peroneal artery. there were no intraseptal or intramuscular vessels in the osteocutaneous septum which connected to the overlying skin paddle. The skin island was salvaged by performing independent microsurgical anastomoses of the fibular graft and the skin paddle. Both patients had complete survival of the fibula and overlying skin paddle.
腓骨骨皮游离皮瓣已成为修复骨与皮肤缺损的常用选择。据报道，皮瓣的可靠性存在潜在缺陷。以往研究强调，如果肌间隔或比目鱼肌中不存在预期的穿支血管，覆盖的皮瓣会完全坏死。本文介绍两例病例，其中发现皮瓣由腓骨近端动脉发出的血管供血。骨皮间隔内没有与覆盖皮瓣相连的肌间隔内或肌内血管。通过对腓骨移植和皮瓣进行独立的显微外科吻合，挽救了皮岛。两名患者的腓骨和覆盖皮瓣均完全存活。
