Abstract：Objective To investigate the clinical effect of the distally based sural neurouascular flap for the reconstruction of the anterior soft tissue defect of foot. Methods Based on anatomy research, the distally based sural neurouascular flap was used in 21 consecutive patients with the forefoot soft tissue defect from January 2004 to January 2013. The cause of trauma as follows: 8 cases were traffic accident injury, 9 cases were crushing injury, 3 cases were machine injury, and 1 case was explosion injury. The area of defect varied from 7.0 cm×5.0 cm to 22.0 cm×11.0 cm. The rotation point located 1-3 cm above the lateral malleolus, and flap size varied from 8.0 cm×6.0 cm to 25.0 cm×12.0 cm. We anastomosed sural nerve with recipient site nerve to reconstruct the sense of this flap in some cases. Results Although, the different degrees of swelling were found after the operation, all flaps survived. Flaps whose trunk of the superficial vein were ligated distally at the rotation point swelled less serious than those unligated. In 2 cases of flap necrosis occurred at the edge in 3-4 days after the surgery, and phase Ⅱ healing was acquired after dressing change. The other flaps and all donor sites acquired Phase Ⅰ healing. All clinical Results were satisfactory after 5 to 27 months of follow-up. Not only appearance and function of foot-such as walking and loading-were reconstructed, but also all donor sites recovered with no complications. In 5 cases of this group which were conducted anastomosis of cutaneous nerve, sense of touch and pain restored in different degrees 1 year after the surgery, and the two-point discrimination was 8-10 mm. Conclusions The distally based sural neurouascular flap, with a lower rotation point, can be used to reconstruct the front of the foot soft tissue defect and has a high survival rate. The sense of flap can be restored by anastomosing the sural nerve with the dorsal cutaneous nerve of foot.
张发惠 宋一平 林松庆 郑和平. 腓肠神经营养血管远端蒂皮瓣修复足前部软组织缺损[J]. 中华解剖与临床杂志, 2014, 19(1): 46-48.
Zhang Fahui, Song Yiping, Lin Songqing, Zheng Heping. The distally based sural neurouascular flap for reconstruction of the forefoot soft tissue defect. Chinese Journal of Anatomy and Clinics, 2014, 19(1): 46-48.
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2014, Vol. 19 
