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目的:观察以带蒂的隐神经营养皮瓣配合中药治疗一期修复踝关节损伤伴软组织缺损的临床疗效。方法:对16例伴有膝踝关节部位软组织缺损的踝关节损伤患者,先行急诊清创,再设计以带蒂隐神经营养皮瓣,对缺损的软组织进行修复,术后内服中药汤剂治疗。结果:本组16例所有皮瓣术后充盈良好;4例出现瘀血情况,经处理后好转;1例带血管蒂的岛状皮瓣边缘出现坏死,经换药后愈合。供区创面均一期愈合。随访10～24月,平均16月,结果1例作二期修整外,其余皮瓣外形满意。患踝、足按美国足踝外科协会踝部评分标准进行评估,结果优6例,良9例,可1例,差0例,优良率为93.75%。结论:带蒂的隐神经营养皮瓣配合中药内服是治疗伴有软组织缺损的踝关节损伤的有效方法。
Objective: To observe the pedicle of the saphenous nerve nutrition flap with Chinese medicine treatment of ankle joint repair with soft tissue defects in the clinical efficacy. Methods: Twenty - six patients with ankle joint injuries associated with knee and ankle joint soft tissue defects were treated with emergency debridement and then pedicled with pedicled saphenous nerve nutrient flap to repair the damaged soft tissues. After oral administration of Chinese herbal decoction. Results: All the flaps in 16 cases were well filled after operation. The bleeding in 4 cases was improved after treatment. The necrosis was found on the edge of the island flap with vascular pedicle and healed after dressing change. Wound for the area were healing. Follow-up 10 to 24 months, an average of 16 months, the results of a second-stage dressing, the other skin shape satisfaction. Ankle and foot according to the American Society of Ankle and Foot Ankle scoring criteria for evaluation, the results were excellent in 6 cases, good in 9 cases, fair in 1 case, poor in 0 cases, excellent and good rate was 93.75%. Conclusion: pedicled saphenous neurotrophic flap with Chinese medicine orally is an effective method for the treatment of ankle joint injuries associated with soft tissue defects.