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目的观察低旋转点隐神经营养血管远端蒂皮瓣修复儿童大面积足跟部贴骨瘢痕的临床效果。方法大面积足跟贴骨瘢痕患儿9例,年龄5~13岁;出现瘢痕至修复间隔时间4个月~4年;足跟瘢痕面积4cm×5cm~11cm×15cm。采用低旋转点隐神经营养血管远端蒂皮瓣修复足跟瘢痕,术后24~36h拔除引流。3周左右开始行皮瓣蒂部夹蒂延迟训练;4周左右断蒂,并开始功能锻炼。结果术后随访6~27个月,转移皮瓣全部成活;足跟部移植皮瓣质地松软不臃肿,外形满意,穿鞋行走局部皮肤无破溃。踝关节活动范围:背伸5~30度,跖屈8~35度。2例感觉恢复差。结论低旋转点隐神经营养血管远端蒂皮瓣修复儿童大面积足跟部贴骨瘢痕效果良好。
Objective To observe the clinical effect of distal pedicle flap of saphenous nerve nutrient vessel with low revolving point in repairing the cicatrix of large heel in children. Methods Nine healed children with heel and scalloped scars were aged 5 to 13 years old. The time from scar to repair was 4 months to 4 years. The heel scar area was 4cm × 5cm ~ 11cm × 15cm. The low rotation point of saphenous nerve nutrient vascular distal pedicel flap repair heel scar, removal of drainage after 24 ~ 36h. 3 weeks or so began pedicle flap pedicle pedicle delayed training; 4 weeks or so, and began functional exercise. Results The follow-up of 6 to 27 months postoperatively showed that all the transplanted flaps survived. The flaps of the heel graft were soft and not bloated, and the shape of the skin was satisfactory. Ankle range of motion: dorsiflexion 5 to 30 degrees, plantar flexion 8 to 35 degrees. 2 cases feel poor recovery. Conclusion The low revolving point of saphenous nerve nutrient vessels distal pedicle flap pedicle cicatricial heel prosthesis with a good effect.