CAJ | 학술논문

目的探讨儿童足跟部严重损伤的骨及软组织修复方法.方法对9例(11侧患肢)儿童新鲜的足跟部严重损伤患儿急诊实施跟骨皮质包埋跟腱法修复跟骨及跟腱,腓动脉穿支蒂皮瓣逆行转移修复软组织缺损,伴有足底皮肤缺损的患儿同时行腓肠外侧皮神经移位后用于感觉恢复,术后随访1年.结果临床9例(11侧患肢)手术均顺利完成,所有跟骨及跟腱均愈合良好,皮瓣均成活,随访1年,皮瓣血运良好,质地柔软.踝关节屈伸平均达48°,接近健侧.修复足底的皮瓣共4例,感觉恢复达S3+,两点分辨率为7～10 mm.结论儿童足跟部严重损伤采用跟骨皮质包埋跟腱法修复跟骨及跟腱,腓动脉穿支蒂皮瓣逆行转移修复软组织缺损,其手术方式安全、可靠,腓肠外侧皮神经用于修复足底感觉时效果良好.
목적 탐토인동족근부엄중손상적골급연조직수복방법.방법 대9례(11측환지)인동신선적족근부엄중손상환인급진실시근골피질포매근건법수복근골급근건,비동맥천지체피판역행전이수복연조직결손,반유족저피부결손적환인동시행비장외측피신경이위후용우감각회복,술후수방1년.결과 림상9례(11측환지)수술균순리완성,소유근골급근건균유합량호,피판균성활,수방1년,피판혈운량호,질지유연.과관절굴신평균체48°,접근건측.수복족저적피판공4례,감각회복체S3+,량점분변솔위7～10 mm.결론 인동족근부엄중손상채용근골피질포매근건법수복근골급근건,비동맥천지체피판역행전이수복연조직결손,기수술방식안전、가고,비장외측피신경용우수복족저감각시효과량호.
Objective To discuss a new surgical procedure for repairing of soft tissue and bone defect in badly damaged heels of children.Methods Nine cases (11 limbs) of badly damaged heels were performed as emergency operations.The Achilles's tendon was embedded in the cortical bone of calcaneus and the pedicled flap with perforating branch of the peroneal artery was used for repairing the soft tissue defect of the heel.Lateral sural nerve was transferred for the recovery of the thenar sensation.All cases were followed up for one year.Results All operations were performed with no complications.Calcaneus and Achilles's tendon had reunited well.At 12 months postoperatively,the flap had good blood supply and soft texture.Ankle function was similar to the normal side,with an average arc of motion of 48°.The sensitivity of the flaps with nerve transferring (4 cases of plantar defect) reaches S3+,2-PD was 7 mm to 10 mm.Conclusions The technique of Achilles's tendon embedded in cortical bone of calcaneus,with calf flap is safe,and reliable for repairing badly damaged heels in children.