Objective: To investigate the effectiveness of groin flap with external oblique aponeurosis in repair of tendon and skin defects of dorsal foot.
Methods: Between October 2016 and January 2020, 12 patients with compound tissue defects of the dorsal foot caused by trauma were treated. There were 9 males and 3 females, with a median age of 42 years (range, 32-65 years). The size of the skin defects ranged from 8 cm×5 cm to 12 cm×8 cm. All wounds were accompanied by extensor tendon injury, including 6 cases of extensor hallucis longus tendon defect, 5 cases of extensor digitalis longus tendon defect, and 3 cases of extensor digitalis longus tendon and extensor digitorum brevis defects. The interval between injury and admission was 1-6 hours (mean, 3 hours). After admission, the wounds were thoroughly debrided, and the groin flap with external oblique aponeurosis was used to repair the skin and tendon defects in the second stage. The size of skin flap ranged from 10 cm×6 cm to 13 cm×9 cm, and the size of the external oblique aponeurosis ranged from 5.5 cm×3.0 cm to 8.0 cm×5.0 cm. The wounds at donor sties were sutured directly.
Results: All flaps survived completely without significant complications. All incisions of the recipient and donor sites healed by first intention. All patients were followed up 16-24 months (mean, 18 months). The flaps were satisfactory in appearance and soft in texture. At last follow-up, 9 cases were excellent and 3 cases were good according to the American Orthopaedic Foot and Ankle Society (AOFAS) metatarsophalangeal-interphalangeal joint scale criteria. The toe function was satisfactory. The line scar was left without hernia or other morbidity on the donor site.
Conclusion: The groin flap with the external oblique aponeurosis can repair the tendon and skin defects of the dorsal foot, with concealed donor site, easy dissection and adjustable thinness, as well as the enough tough aponeurosis.
目的: 探讨携带腹外斜肌腱膜的髂腹股沟皮瓣修复足背肌腱及皮肤缺损的疗效。.
方法: 2016年10月—2020年1月，收治12例外伤导致的足背复合组织缺损。男9例，女3例；年龄32～65岁，中位年龄42岁。足背皮肤软组织缺损范围为8 cm×5 cm～12 cm×8 cm；创面均伴伸肌腱损伤，其中踇长伸肌腱缺损6例，趾长伸肌腱缺损5例，趾长、短伸肌腱缺损3例。受伤至入院时间为1～6 h，平均3 h。入院后急诊彻底清创，二期采用携带腹外斜肌腱膜的髂腹股沟皮瓣修复足背创面及肌腱缺损。皮瓣切取范围为10 cm×6 cm～13 cm×9 cm，腹外斜肌腱膜切取范围为5.5 cm×3.0 cm～8.0 cm×5.0 cm。供区直接缝合关闭。.
结果: 术后12例皮瓣全部成活，供、受区创面均Ⅰ期愈合。患者均获随访，随访时间16～24个月，平均18 个月。皮瓣外形满意、质地柔软。末次随访时，根据美国矫形足踝协会（AOFAS）跖趾-趾间关节量表评分获优9例、良3例；伸趾功能重建满意。供区仅遗留线性瘢痕，未出现腹壁疝等并发症。.
结论: 髂腹股沟皮瓣供区隐蔽，切取位置表浅、易于修薄，可携带腹外斜肌腱膜修复肌腱缺损，是一期修复足背肌腱及皮肤缺损的理想皮瓣。.
Keywords: Groin flap; dorsal foot; external oblique aponeurosis; soft tissue defect; tendon defect; wound repair.