Effectiveness of medial ankle branches propeller “Tennis racket-like” flap in repair of heel-ankle tissue defects_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENG Ding ,  CUI Shuying , ZHANG Chengshu , LI Yanling , LI Heng , WANG Xiangling , WANG Jun , ZHENG Le

Department of Burns and Plastic Surgery, Pingdingshan Traditional Pingmei Shenma Medical Hospital, Pingdingshan Henan, 467000, P.R.China;

Corresponding author：

CUI Shuying, Email: yuxiangchengding@126.com

Keywords：

Medial ankle branches flap; propeller flap; heel-ankle tissue defect

DOI：

10.7507/1002-1892.201804030

Video：

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Objective To investigate effectiveness of the medial ankle branches propeller " Tennis racket-like” flap in repair of heel-ankle tissue defect. Methods Between June 2011 and June 2016, 50 patients with heel-ankle tissue defects were treated. There were 40 males and 10 females, with a median age of 35.6 years (range, 6–58 years). The defects were caused by trauma in 44 cases, scar deformity after trauma in 2 cases, chronic ulcer in 2 cases, and squamous cell carcinoma in 2 cases. The defects located at heel in 20 cases, ankle in 15 cases, and heel-ankle in 15 cases. The size of heel-ankle tissue defect ranged from 3.5 cm×2.0 cm to 13.0×10.0 cm. The course of disease ranged from 3 hours to 2 months (mean, 28 days). All wounds were repaired by the medial ankle branches propeller " Tennis racket-like” flap in a size of 3.8 cm×2.2 cm–13.4 cm×10.3 cm. The donor site was directly sutured in 5 cases or repaired by skin grafting in 45 cases. Results All flaps survived and wounds healed by first intention. Partial necrosis of skin grafting occurred in 1 case, and the wound recovered by change dressing. The other skin grafting survived and wounds healed by first intention. Forty-eight patients were followed up 12 months after operation. The appearance, sensory, and function of repaired heel-ankle flaps were satisfactory. Conclusion For heel-ankle tissue defect repair, the medial ankle branches propeller " Tennis racket-like” flap has advantages of the high survival rate, reliable blood supply, and sensory recovery.

Citation： CHENG Ding, CUI Shuying, ZHANG Chengshu, LI Yanling, LI Heng, WANG Xiangling, WANG Jun, ZHENG Le. Effectiveness of medial ankle branches propeller “Tennis racket-like” flap in repair of heel-ankle tissue defects. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(11): 1450-1453. doi: 10.7507/1002-1892.201804030 Copy

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6.	Zhao TL, Tang Y, Yu DJ, et al. The application of narrow pedicle flaps in repairing facial defects. J Plast Reconstr Aesthet Surg, 2011, 64(7): 970-972.
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8.	伍丽君, 赵天兰, 余道江, 等. 缺氧缺血型狭长窄蒂皮瓣成活过程中 SDF-1 表达的实验研究. 中华整形外科杂志, 2012, 28(3): 199-202.
9.	赵天兰, 余道江, 谢晓明, 等. 狭长窄蒂皮瓣在面额部皮肤癌治疗中的应用. 中华整形外科杂志, 2012, 28(3): 181-184.
10.	魏在荣, 王玉明, 王达利, 等. 胫后动脉内踝上肌间隙支逆行岛状皮瓣的解剖观察及临床应用. 中华整形外科杂志, 2007, 23(4): 293-294.
11.	王成琪. 王成琪显微外科学. 济南: 山东科学技术出版社, 2009: 255-256.
12.	黄继峰, 王增涛, 郭德亮, 等. 胫后动脉皮支筋膜皮瓣的解剖及临床应用. 中国修复重建外科杂志, 2000, 14(4): 217-219.
13.	钟世镇, 徐达传, 丁自海. 显微外科临床解剖学. 山东: 山东科学技术出版社, 2000: 102.
14.	彭智, 贾振华, 黄海华, 等. 应用小腿内侧逆行带蒂皮瓣修复足底皮肤缺损. 中华显微外科杂志, 2011, 34(1): 31-33.
15.	林松庆, 林凤英, 张发惠. 内踝前穿支蒂隐神经营养血管皮瓣的临床应用. 中华显微外科杂志, 2010, 33(2): 112-114.
16.	芮永军, 张雁, 杨红, 等. 术前不同定位方法在股前外侧穿支皮瓣应用的对比分析. 中华显微外科杂志, 2015, 38(1): 33-37.
17.	侯春林, 顾玉东. 皮瓣外科学. 上海: 上海科学技术出版社, 2006: 647-648.

1. Song D, Deng X, Chen Y, et al. Thinned chimeric radial collateral artery perforator flap in complex distal thumb reconstruction. Arch Orthop Truama Surg, 2015, 135(11): 1623-1631.
2. 张世民, 王欣, 唐茂林, 等. 穿支皮瓣的争论与当前共识. 中华显微外科杂志, 2014, 37(1): 3-4.
3. Yücel A, Senyuva C, Aydin Y, et al. Soft-tissue reconstruction of sole and heel defects with free tissue transfers. Ann Plast Surg, 2000, 44(3): 259-268.
4. 余道江, 赵天兰, 徐又佳, 等. 应用耳后窄蒂皮下蒂皮瓣修复耳廓内软组织缺损. 中国修复重建外科杂志, 2012, 26(6): 721-723.
5. 余道江, 赵天兰, 徐又佳, 等. 负压封闭引流技术在狭长窄蒂皮瓣中的应用. 中华整形外科杂志, 2013, 29(1): 62-64.
6. Zhao TL, Tang Y, Yu DJ, et al. The application of narrow pedicle flaps in repairing facial defects. J Plast Reconstr Aesthet Surg, 2011, 64(7): 970-972.
7. Kim JT, Ng SW, Kim YH. Application of various compositions of thoracodorsal perforator flap for craniofacial contour deformities. J Plast Reconstr Aesthet Surg, 2011, 64(7): 902-910.
8. 伍丽君, 赵天兰, 余道江, 等. 缺氧缺血型狭长窄蒂皮瓣成活过程中 SDF-1 表达的实验研究. 中华整形外科杂志, 2012, 28(3): 199-202.
9. 赵天兰, 余道江, 谢晓明, 等. 狭长窄蒂皮瓣在面额部皮肤癌治疗中的应用. 中华整形外科杂志, 2012, 28(3): 181-184.
10. 魏在荣, 王玉明, 王达利, 等. 胫后动脉内踝上肌间隙支逆行岛状皮瓣的解剖观察及临床应用. 中华整形外科杂志, 2007, 23(4): 293-294.
11. 王成琪. 王成琪显微外科学. 济南: 山东科学技术出版社, 2009: 255-256.
12. 黄继峰, 王增涛, 郭德亮, 等. 胫后动脉皮支筋膜皮瓣的解剖及临床应用. 中国修复重建外科杂志, 2000, 14(4): 217-219.
13. 钟世镇, 徐达传, 丁自海. 显微外科临床解剖学. 山东: 山东科学技术出版社, 2000: 102.
14. 彭智, 贾振华, 黄海华, 等. 应用小腿内侧逆行带蒂皮瓣修复足底皮肤缺损. 中华显微外科杂志, 2011, 34(1): 31-33.
15. 林松庆, 林凤英, 张发惠. 内踝前穿支蒂隐神经营养血管皮瓣的临床应用. 中华显微外科杂志, 2010, 33(2): 112-114.
16. 芮永军, 张雁, 杨红, 等. 术前不同定位方法在股前外侧穿支皮瓣应用的对比分析. 中华显微外科杂志, 2015, 38(1): 33-37.
17. 侯春林, 顾玉东. 皮瓣外科学. 上海: 上海科学技术出版社, 2006: 647-648.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of medial ankle branches propeller “Tennis racket-like” flap in repair of heel-ankle tissue defects

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