带腓肠肌肌腱的腓肠神经营养血管复合皮瓣修复跟腱并皮肤缺损

中国临床解剖学杂志 ›› 2010, Vol. 28 ›› Issue (2): 222-.

带腓肠肌肌腱的腓肠神经营养血管复合皮瓣修复跟腱并皮肤缺损

董忠根¹，王志华²，　刘立宏¹，　倪江东¹，　何爱咏¹

1. 中南大学湘雅二医院骨科，长沙 410011；　2. 湖南省郴州市一医院，湖南郴州 423000

收稿日期:2009-06-30 出版日期:2010-03-25 发布日期:2010-04-13
作者简介:董忠根（1965-），男，湖南郴州人，医学博士，副教授，硕士生导师，主要从事手外科与创伤显微修复，Tel：（0731）85295126

Sural neurofasciocutaneous composite flap with gastrocnemius tendon for repairing defects of Achilles tendon and overlying skin

DONG Zhong-gen, WANG Zhi-hua, LIU Li-hong, et al.

Department of Orthopaedics, 2nd Xiang Ya Hospital, Central South University, Changsha 410011, China

Received:2009-06-30 Online:2010-03-25 Published:2010-04-13

摘要/Abstract

摘要：

目的探讨带腓肠肌肌腱的腓肠神经营养血管复合皮瓣修复跟腱并皮肤缺损的效果。方法复合皮瓣修复跟腱并皮肤缺损6例，其中3例跟腱背侧部分缺损，2例跟腱内侧部分缺损，1例跟腱完全缺损。切取带腓肠肌肌腱的腓肠神经营养血管复合皮瓣时，保持肌腱与皮瓣深筋膜的联系。皮瓣大小7 cm×5 cm~11 cm×10 cm, 腓肠肌肌腱大小为5 cm×3 cm~9 cm×4 cm。结果 6例皮瓣均完全成活，感染控制；6例术后随访3~50个月，皮瓣外观满意，无跟腱再断裂者。患侧踝关节屈伸范围基本正常，功能评定，优5例，良1例。结论带腓肠肌肌腱的腓肠神经营养血管复合皮瓣修复跟腱并皮肤缺损具有手术操作简单，术后跟腱粘连轻，功能恢复好的优点。

关键词: 腓肠肌肌腱, 腓肠神经, 外科皮瓣, 跟腱, 软组织缺损

Abstract:

Objective　To report the clinical effects of sural neurofsciocutaneous composite flap with gastrocnemius tendon on repairing defect of Achilles tendon and overlying skin. Methods　Six cases of defects of Achilles tendon and overlying soft tissue were reconstructed by the sural neurofasciocutaneous composite flap with gastrocnemius tendon. Be sure to keep the connection between gastrocnemius tendon and deep fascia of the composite flap during the surgery. The smallest and the largest areas of transfered skin flaps were 7cm× 5cm and 11cm×10cm respectively. The size of gastrocnemius tendon were about 5cm×3cm to 9cm×4cm. Results　All of the six flaps survived well, without obvious infection. The 3-50 months' of follow-up showed that the functions of Achilles tendon and the appearance of the flaps of 6 patients were satisfactory, with no Achilles tendon disruption appeared. Conclusions　Sural neurofsciocutaneous composite flap with gastrocnemius tendon is easy to operate in repairing defect of Achilles tendon and overlying skin, with only slight syncretio of Achilles tendon, and excellent function recovery of ankle joint.

Key words: Gastrocnemius tendon, Sural nerve, Skin flap, Achilles tendon, Soft tissue defects

中图分类号:

董忠根, 王志华, 刘立宏, 倪江东, 何爱咏. 带腓肠肌肌腱的腓肠神经营养血管复合皮瓣修复跟腱并皮肤缺损[J]. 中国临床解剖学杂志, 2010, 28(2): 222-.

DONG Zhong-Gen, WANG Zhi-Hua, LIU Li-Hong, NI Jiang-Dong, HE Ai-Yong. Sural neurofasciocutaneous composite flap with gastrocnemius tendon for repairing defects of Achilles tendon and overlying skin[J]. Chinese Journal Of Clinical Anatomy, 2010, 28(2): 222-.

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