CAJ | 학술논문

目的在解剖学研究基础上,探讨以携带部分腓骨长肌腱的腓骨肌腱鞘筋膜与脂肪筋膜复合皮瓣,修复伴有跟腱缺损的小腿下段难治性组织缺损的可行性.方法在前期临床应用腓骨肌腱鞘筋膜与脂肪筋膜瓣联合转移修复跟后、小腿下段及踝周难治性深度组织缺损的基础上,改进为腓骨肌腱鞘筋膜与脂肪筋膜及腓骨长肌腱复合皮瓣,用于修复伴有跟腱缺损的小腿下段难治性组织缺损.结果 2006年以来应用携带部分腓骨长肌腱的腓骨肌腱鞘筋膜与脂肪筋膜复合皮瓣修复伴有跟腱缺损的小腿下段难治性组织缺损6例,设计应用复合皮瓣最大达5 cm×5cm,携带腓骨长肌腱最长达5 cm.术后除1例供区移植皮片与皮瓣蒂部交界处部分表皮糜烂延迟愈合外,其余病例复合皮瓣完全成活.术后随访5个月至2年,功能、外形恢复满意.结论腓骨肌腱鞘筋膜及腓骨长肌腱复合皮瓣血供可靠,就近取材,手术简便,供区损伤少,是I临床修复伴有跟腱缺损的小腿下段中小面积难治性组织缺损创面的理想选择.
목적 재해부학연구기출상,탐토이휴대부분비골장기건적비골기건초근막여지방근막복합피판,수복반유근건결손적소퇴하단난치성조직결손적가행성.방법 재전기림상응용비골기건초근막여지방근막판연합전이수복근후、소퇴하단급과주난치성심도조직결손적기출상,개진위비골기건초근막여지방근막급비골장기건복합피판,용우수복반유근건결손적소퇴하단난치성조직결손.결과 2006년이래응용휴대부분비골장기건적비골기건초근막여지방근막복합피판수복반유근건결손적소퇴하단난치성조직결손6례,설계응용복합피판최대체5 cm×5cm,휴대비골장기건최장체5 cm.술후제1례공구이식피편여피판체부교계처부분표피미란연지유합외,기여병례복합피판완전성활.술후수방5개월지2년,공능、외형회복만의.결론 비골기건초근막급비골장기건복합피판혈공가고,취근취재,수술간편,공구손상소,시I림상수복반유근건결손적소퇴하단중소면적난치성조직결손창면적이상선택.
Objective To investigate the feasibility of using modified peroneal tendofascial compound flap with partial tendon of peroneal long muscle in lower leg refractory defect with Achilles tendon rupture. Methods Based on the application experience of peroneal tendofascial compound flap for lower leg refractory defects, partial tendon of peroneal long muscle was included in the flap to repair the Achilles tendon rupture. Results 6 cases were treated. The maximum size of modified compound flap reached 5 cm x S cm. The maximal included tendon in the flap was S cm in length. All the flaps survived completely. Partial epidermis necrosis happened in one case between the skin graft at the donor site and the edge of the flap pedicle. The patients were followed up for 5 months to 2 years with satisfactory cosmetic and functional results. Conclusions The modified compound flap has reliable blood supply and can be easily transposed, leaving less morbidity at the donor site. It is very suitable for lower leg refractory defect with the Achilles tendon rupture.