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1、旋髂深血管蒂髂骨皮瓣移植再造跖骨并重建足弓姚忠軍等.旋髂深血管蒂髂骨皮瓣移植再造跖骨并重建足弓?l45?
[文章編號]1006—9674(2004)03—0l45一O4
旋髂深血管蒂髂骨皮瓣移植
再造跖骨并重建足弓
姚忠軍.,何明武
(鄖陽醫(yī)學(xué)院附屬太和醫(yī)院創(chuàng)傷骨科,湖北十堰442000)
[摘要]目的:探討旋髂深血管蒂髂骨皮瓣移植再造跖骨并重建足弓的手術(shù)要點及臨床療效,為前足創(chuàng)傷性復(fù)合
組織缺損的修復(fù)提供一種新術(shù)式.方法:自1998年5月～2003年1O月,應(yīng)用吻合旋髂深血管的髂骨皮瓣移植,I
期修復(fù)跖骨缺損伴前足軟組織缺損并重建足弓7例,隨訪3～24個月,平均18個月.結(jié)果:7例均成活,其
2、中1例髂
骨皮瓣邊緣少許壞死經(jīng)換藥處理后愈合;復(fù)查x線片示:術(shù)后3～4個月達骨性愈合,再造跖骨成活良好,無骨壞死
吸收及骨不連發(fā)生,重建足弓形態(tài)滿意,可恢復(fù)負重行走功能.結(jié)論:旋髂深血管解剖恒定,管徑粗大,血管蒂長.髂
骨皮瓣血供豐富,移植手術(shù)操作簡便,可同時修復(fù)多個跖骨缺損,髂骨瓣的骨質(zhì)及弧度,厚度與跖骨相似,重建足弓
符合足弓的生物力學(xué)特性,是修復(fù)前足創(chuàng)傷性復(fù)合組織缺損的好方法.
[關(guān)鍵詞]髂骨皮瓣;重建;跖骨;足弓;旋髂深血管
[中圖法分類號]R658[文獻標識碼]A
ReconstructionofMetatarsusandArchofFootUsingIliacOsteocutahe
3、ousFreeFlapsBasedontheDeepCircumflexIliac
VesselsYAOZhong—jun.HEMing—WU(TheDepartmenlofOsteopidics,r』ihehospital,Yu一.
nyangMedicalcol
lege.Shiyan.Hubei442000)
Abstract:ObjectiveTodiscusstheessential0foperationandcliniceffectofthetransplantation0ftheiliacosteocutane—
OUScompositeflapsbasedOilthedeepc
4、ircumflexiliac,resselsforreconstructingthemetatarsusandthearchoffoot.
TodesignanewmethodforrepairingthecompositetissuesdefectOfforefoot.MethodsFromMayl998tO()ctober
2003.theiliacosteocutaneousfreeflapsvascularizedbythedeepcircumflexiliacvesselswereusedtOreconstructthe
metatarsusandthearchoffoot.repa
5、irthesofttissuesdefectofforefootatonestageon7cases.l’hefollow—upperiod
rangedfrom3tO24months,withanaverageof18months.ResultAlltheflapssurvived.thoughoileflaphadsome
necrosisontheedgeportion,whichhealedbychangingdressing.After3tO4monthspostoperation.X—rayshowthat
thebonejointedtogetherandthecomposite
6、flapsurvivedcompletely,Therewasnocomplicationofosteonecrosisor
non—union,theshapeofreconstructedarchesofthelootswassatistactory.Thepatientsrecoveredfullweightbearing
capabilityafterayear.OonclusionTheanatomyofdeepcircumflexiliacvesselsiseternal,thevasculardiametersizeal—
lowsgreaterreliabilityforthe
7、microvascularanastomosis,thepedicelislongenough,theiliacosteocutaneousflaphas
adequatebloodsupply,operationissimple,multiplemetatarsusdefectscanbereconstructedatonesetting.theilium
closelyapproximates
