目的 评估第1跖骨间隙近端穿支蒂皮神经营养血管皮瓣修复前足软组织缺损的临床疗效。 方法 2014年3月至2019年11月，根据第1跖骨间隙近端穿支蒂皮神经营养血管皮瓣术式的解剖资料，在足背内侧切取面积为6.0 cm×4.9 cm~3.0 cm×2.1 cm穿支蒂皮神经营养血管皮瓣，转位修复前足损伤8例。 结果 8例皮瓣全部顺利成活，供区创面修复良好，术后随访3~12个月，皮瓣质地良好，触之有弹性，色泽与周围无明显差异，患者对外观及功能满意。 结论 第1跖骨间隙近端穿支蒂皮神经营养血管皮瓣血供丰富，为前足软组织缺损修复提供了新的选择，手术方法简便实用、血供可靠。
Objective To explore the clinical efficacy of the first metatarsal proximal perforator-based neurocutaneous vascular flap for repairing the forefoot soft-tissue defects. Methods From March 2014 to November 2019, eight patients with forefoot defects were reconstructed by the first metatarsal proximal perforator-based neurocutaneous vascular flaps with an average size from 6.0 cm×4.9 cm to 3.0 cm×2.1 cm. Results All flaps survived completely and the donor sites healed uneventfully. After a follow-up of 3 to 12 months, the flaps presented an excellent texture, a fine elasticity, and a similar skin color. And the patients were satisfied with both the functions and appearances of the donor and recipient regions. Conclusions Due to the good and reliable blood supply and the simple and practical surgical procedure, the first metatarsal proximal perforator-based neurocutaneous vascular flap might become a new choice for the repair of forefoot soft-tissue defects.
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