[1]石建国,杨彦君,王继宏,等.改良与传统逆行腓肠神经营养血管筋膜皮瓣修复足踝部软组织缺损的疗效对比[J].中国美容医学,2024,(7):100-103.
　SHI Jianguo,YANG Yanjun,WANG Jihong,et al.Comparison of the Effi cacy of Modifi ed and Traditional Retrograde Sural Neurofasciocutaneous Flap for Repairing Foot and Ankle Soft Tissue Defects[J].Medical Aesthetics and Beauty,2024,(7):100-103.
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改良与传统逆行腓肠神经营养血管筋膜皮瓣修复足踝部软组织缺损的疗效对比()
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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:
期数:
2024年7期
页码:
100-103
栏目:
出版日期:
2024-07-10

文章信息/Info

Title:
Comparison of the Effi cacy of Modifi ed and Traditional Retrograde Sural Neurofasciocutaneous Flap for Repairing Foot and Ankle Soft Tissue Defects
文章编号:
1008-6455（2024）07-0100-04
作者:
石建国; 杨彦君; 王继宏; 高彦龙; 田 斐
(庆阳市人民医院手足显微外科 甘肃 庆阳 745000 )
Author(s):
SHI Jianguo;  YANG Yanjun;  WANG Jihong;  GAO Yanlong;  TIAN Fei
( Department of Hand and Foot Microsurgery, Qingyang People’s Hospital, Qingyang 745000, Gansu, China )
关键词:
足踝; 软组织缺损; 逆行腓肠神经营养血管筋膜皮瓣; 整形修复; 感觉功能 [
Keywords:
foot and ankle;  soft tissue defect;  retrograde sural neurotrophic vascular fascial fl ap;  plastic repair;  sensory function
分类号:
R622
文献标志码:
A
摘要:
目的：探究比较改良与传统逆行腓肠神经营养血管筋膜皮瓣修复足踝部软组织缺损的疗效。方法：回顾性选取2019年 1 月-2022年9月于笔者医院接受逆行腓肠神经营养血管筋膜皮瓣修复的足踝部软组织缺损患者80例为研究对象，根据术中是 否保留腓肠神经将患者分为传统组（切断腓肠神经并携带其于皮瓣内，n=34）和改良组（保留腓肠神经及其外膜于供区或进 一步分离腓肠神经外膜，n=46）。统计比较两组患者手术相关指标、足踝功能（美国矫形外科足踝协会Maryland足功能评分 系统）、感觉功能（英国医学研究会感觉功能评定标准）及患者的美观满意度。结果：两组患者皮瓣成活率均为100.00%， 改良组手术时间长于传统组，两点辨别觉（2-point discrimination，2PD）差值小于传统组（P＜0.05）。术后6个月，两 组患者Maryland足功能评分、修复美观度满意率比较差异无统计学意义（P＞0.05）；改良组感觉功能分级S3～S4级比例高 于传统组（P＜0.05）。结论：逆行腓肠神经营养血管筋膜皮瓣修复足踝部软组织缺损疗效好，美观度较高。术中保留腓肠 神经有利于术后神经支配区感觉恢复，但手术时间较长，临床应对患者情况进行综合评估，选择合适的手术方式。
Abstract:
Objective To compare the effi cacy of modifi ed and traditional retrograde sural neurotrophic vascular fasciocutaneous fl ap in repairing soft tissue defects of foot and ankle. Methods A total of 80 patients with foot and ankle soft tissue defects who underwent retrograde sural neurofasciocutaneous fl ap repair in the author’s hospital between January 2019 and September 2022 were reviewed. According to the treatment of sural nerve during operation, the patients were divided into traditional group ( fl aps carrying cutting-off sural nerve, n=34) and modifi ed group (reserving sural nerve and its outer membrane in the donor area or further separating the sural epineurium, n=46). The surgery-related indicators, foot and ankle function (American Orthopaedic Foot and Ankle Society Maryland Foot function scoring system), sensory function (British Medical Research Council sensory function evaluation criteria) and aesthetic satisfaction of patients were statistically compared between the two groups. Results All fl aps in the two groups survived. Operation time of modifi ed group was longer than that of traditional group, and 2-point discrimination (2PD) was smaller than that of traditional group (P ＜0.05). There was no signifi cant diff erence in Maryland foot function score or satisfaction with aesthetics after repair between the two groups at 6 months after operation (P ＞0.05). The proportion of grade S3-S4 sensory function in modifi ed group was higher than that in traditional group (P ＜0.05). Conclusion Applying retrograde sural neurofasciocutaneous fl aps to repair foot and ankle soft tissue defects can achieve good repair eff ect and high aesthetics. Preserving the sural nerve during operation is benefi cial for postoperative sensory recovery in the innervated area, but the operation time is longer. In clinical practice, the patient’s condition should be evaluated comprehensively to choose an appropriate operation method.

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更新日期/Last Update: 2024-07-10