Clinical application of medial plantar artery flap carrying sensory nerve in repairing soft tissue defect of heel
XIAO Rong， WANG Jian-hua， WU Yu-qiang
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (4) : 433-435.
Clinical application of medial plantar artery flap carrying sensory nerve in repairing soft tissue defect of heel
Objective To investigate the clinical efficacy of medial plantar artery flap carrying sensory nerve in repairing soft tissue defects in heel area. Methods From June 2016 to November 2017, 12 patients with calcaneal nodule defect (less than 1 cm in length) were treated in our hospital. The medial plantar artery flap carrying sensory nerve was used to repair the wound. The wound area ranged from 3 cm × 4 cm to 10 cm × 6 cm. The flap size ranged from 3.5 cm × 4.5 cm to 11 cm × 7 cm. The clinical efficacy was evaluated by observing the appearance, blood flow, elasticity and two-point discrimination of the flap. Results All flaps survived completely. 10 cases were followed up for 6~14 months. The flaps were satisfactory in appearance without bulkiness, soft in texture, good in elasticity. The two-point discrimination was 5 mm to 9 mm. 8 patients with no bone defect wore shoes, 2 patients with bone defect and without walking limitation needed to wear heeled shoes with soft soles and walk half an hour to feel local tingling pain. Conclusions The medial plantar artery flap with the sensory nerve can better reconstruct the appearance, sensation and function of the heel. It is an effective way to repair the soft tissue defect of the heel.
/ Surgical flaps / Medial plantar artery / Soft tissue defect / Heel
[1] Yang D, Yang JF, Morris SF, et al. Medial plantar artery perforator flap for soft-tissue reconstruction of the heel[J]. Ann Plast Surg, 2011, 67(3): 294-298.
[2] 黄东, 欧阳海洋, 吴伟炽， 等. 足部皮肤软组织缺损皮瓣修复的选择[J].中华显微外科杂志, 2013, 36(6): 577-579.
[3] 刘兴邦, 王运涛, 陶圣祥, 等. 腓肠神经营养血管逆行皮瓣修复足跟部软组织缺损[J]. 实用手外科杂志, 2016, 30(4): 395-396,399.
[4] 王峰, 沈家泰, 胡建波，等. 隐神经大隐静脉营养血管皮瓣修复小腿及足跟部软组织缺损[J]. 临床骨科杂志, 2017, 20(1): 67-69.
[5] 周洪翔, 周涛, 马明明, 等. 不同皮瓣修复足跟软组织缺损的疗效分析[J]. 中华创伤杂志, 2017, 33(8): 750-755..
[6] 唐举玉, 李康华, 谢松林, 等. 股前外侧皮瓣修复足跟大面积软组织缺损的感觉重建探讨[J]. 中华显微外科杂志, 2012,35(4): 267-271..
[7] Oh SJ, Moon M, Cha J, et al. Weight-bearing plantar reconstruction using versatile medial plantar sensate flap[J]. J Plast Reconstr Aesthet Surg, 2011, 64(2): 248-254.
[8] 魏在荣. 皮瓣血供模式分类方式初步报告[J]. 遵义医学院学报, 2012,35(4): 344-346.
[9] Kuran I, Turgut G, Bas L, et al. Comparison between sensitive and nonsensitive free flaps in reconstruction of the heel and plantar area[J]. Plast Reconstr Surg, 2000, 105(2): 574-580.
[10] 唐举玉, 魏在荣, 张世民， 等. 穿支皮瓣的临床应用原则专家共识[J]. 中国临床解剖学杂志, 2016, 34(1): 4-5.
[11] Siddiqi MA, Hafeez K, Cheema TA, et al.The medial plantar artery flap: a series of cases over 14 years[J]. J Foot Ankle Surg, 2012, 51(6):790-794.
[12] 欧阳海洋, 牟勇, 吴伟炽, 等. 足内侧穿支皮瓣设计的解剖基础[J]. 中国临床解剖学杂志, 2014, 32(2): 141-144.
[13] 曹广超, 郑大伟, 孙峰, 等. 预构感觉皮瓣修复足跟软组织撕脱伤[J].中国修复重建外科杂志, 2015, 29(2): 198-201.
[14] 王加利, 赵春霞, 陈仲华, 等. 吻合神经的游离髂骨皮瓣修复足跟部复合组织缺损[J].中华显微外科杂志, 2014, 37(1): 35-38.
[15] 刘勇, 张成进, 付兴茂, 等. 跨供区髂骨皮瓣联合感觉神经植入一期修复大面积跟骨与皮肤缺损[J]. 中华创伤骨科杂志, 2013, 15(7): 571-574.
[16] 魏在荣, 王达利, 王玉明, 等. 足底内侧动脉联合皮瓣的应用解剖及在足跟部较大皮肤软组织缺损修复中的应用[J]. 中华医学杂志,2009, 89(22): 1553-1557.
[17] 魏在荣, 王达利, 王玉明, 等. 带隐神经的足内侧复合皮瓣的解剖学研究及临床应用[J]. 中华整形外科杂志, 2008, 24(4): 257-259.
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