逆行腓动脉穿支皮瓣修复踝足部软组织缺损的临床应用

刘全 陈朝山 廖肇山

【摘要】 目的：探究逆行腓動脉穿支皮瓣修复踝足部软组织缺损的临床应用效果。方法：将2021年3月—2022年6月赣州市南康区第一人民医院的80例踝足部软组织缺损患者根据随机数字表法分为对照组40例和观察组40例。对照组进行传统皮瓣手术治疗，观察组则进行逆行腓动脉穿支皮瓣修复治疗。比较两组的手术时间、术后皮瓣坏死率、术后外观情况[温哥华瘢痕量表（VSS）评分]、感觉功能情况[周围神经病损后感觉功能恢复评定表（BMRC）评分]、踝关节功能（AOFAS评分）、患者满意度。结果：观察组的手术时间短于对照组，患者总满意率高于对照组，差异均有统计学意义（P<0.05）；两组的术后皮瓣坏死率比较，差异无统计学意义（P>0.05）；术后3、6个月，观察组的VSS评分均显著低于对照组，BMRC评分情况均显著优于对照组，AOFAS评分优良率均显著高于对照组，差异均有统计学意义（P<0.05）。结论：逆行腓动脉穿支皮瓣修复踝足部软组织缺损的临床应用效果较好，可有效缩短手术时间，改善关节功能、感觉功能及外观状态，更受患者认可。

【关键词】 逆行腓动脉穿支皮瓣 踝足部 软组织缺损

Clinical Application of Reverse Peroneal Artery Perforator Flap in the Repair of Ankle and Foot Soft Tissue Defects/LIU Quan， CHEN Chaoshan， LIAO Zhaoshan. //Medical Innovation of China， 2024， 21（07）： 0-024

[Abstract] Objective： To investigate the clinical application effect of reverse peroneal artery perforator flap in the repair of ankle and foot soft tissue defects. Method： A total of 80 patients with soft tissue defects of ankle and foot in the First People's Hospital of Nankang District， Ganzhou City from March 2021 to June 2022 were divided into control group （40 cases） and observation group （40 cases） according to random number table method. The control group were treated with traditional flap surgery， the observation group were treated with reverse peroneal artery perforator flap. The operation time， postoperative flap necrosis rates， postoperative appearance situation [Vancouver scar scale （VSS） score]， sensory function situation [nerve injuries commit tee of the British medical research council （BMRC） score]， ankle joint function （AOFAS score） and patients' satisfaction of two groups were compared. Result： The operation time of the observation group was shorter than that of the control group， and the total satisfaction rate of the patients was higher than that of the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the postoperative flap necrosis rate between the two groups （P>0.05）. 3 and 6 months after surgery， the VSS scores of the observation group were significantly lower than those of the control group， the BMRC scores were significantly better than those of the control group， the excellent and good rates of AOFAS scores were significantly higher than those of control group， the differences were statistically significant （P<0.05）. Conclusion： The clinical application effect of reverse peroneal artery perforator flap in the repair of ankle and foot soft tissue defects is better， and it can effectively shorten surgical time and improve joint function， sensory function and appearance state， it is more recognized by the patients.

[Key words] Reverse peroneal artery perforator flap Ankle and foot Soft tissue defects

First-author's address： Department of Orthopaedics， the First People's Hospital of Nankang District， Ganzhou City， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2024.07.005

踝足部软组织缺损是临床常见的一類软组织缺损情况，严重影响患者踝足部的功能、外观及其他多方面状态，是临床中诊治需求极高的一类损伤。临床治疗软组织缺损的方式中，手术修复是常见的有效方式，而不同的手术修复术式的临床效果存在一定差异[1-2]，既往临床中多采用腓肠神经营养皮瓣或隐神经皮瓣转移修复踝足部软组织缺损，效果较好的同时，其仍有较大的疗效提升空间。近年来临床中采用逆行腓动脉穿支皮瓣修复本类软组织缺损的研究可见[3-5]，但是其细致的作用研究仍不足，包括对患者踝足部外观、感觉功能及其他多方面的综合应用研究极为匮乏。……