Using Peroneal Artery Perforator Propeller Flap as an Alternative Option of Reconstruction for a Severe Heel Avulsion Injury - A Case Report

使用腓動脈穿通枝螺旋槳式皮瓣重建足跟部嚴重撕脫傷－個案報告

王冠智(Kuan-Chih Wang) ； 黃浩瑋(Hao-Wei Huang) ； 謝式洲(Shyh-Jou Shieh)

《臺灣整形外科醫學會雜誌》 28卷1期 (2019/03) Pp. 55-63

摘要

Background: Severe heel avulsion injuries often lead to partial or complete heel pad necrosis, posing a challenge for reconstructive plastic surgeons. Aims and Objectives: Reconstructive methods for total heel pad necrosis are complex and multifaceted. We describe the case of a patient who underwent total heel pad reconstruction with a propeller flap. We also discuss the reconstruction technique in the light of the available literature. Materials and Methods: Following a traffic accident, a 24-year-old woman suffered a severe distally based heel avulsion injury with subsequent complete necrosis of the heel pad. Serial debridement revealed partial exposure of the plantar fascia and the calcaneal bone. The heel pad was reconstructed using a local fasciocutaneous propeller flap based on a reliable peroneal artery perforator. Although partial necrosis of the distal propeller flap was noted, the heel pad was well restored. Results: At 6 months of follow-up, the patient had returned to her normal life with no functional deficits such as walking or joint range of motion limitations. Conclusion: Propeller flaps have several advantages as follows: they require a short operating time, no need for microsurgical anastomosis, and they are associated with lower morbidity of the donor site. Therefore, propeller flaps represent an alternative option for heel pad reconstruction.

關鍵字

heel necrosis ； propeller flap

並列摘要

背景：嚴重的足跟撕脫傷常會導致部分或完全的足跟墊壞死，對重建整形外科醫師是一項困難挑戰。目的及目標：本文報告一位足跟撕脫傷的病患，後續造成全足跟墊壞死。在這裡，我們提出一個成功利用腓動脈穿通枝螺旋槳皮瓣來重建足跟部的個案報告。並帶入相關文獻回顧和探討。材料及方法：一名24歲女性在一次嚴重交通事故發生後，造成足跟撕脫傷。後續造成足跟墊完全壞死。在連續清創術後發現足底筋膜和跟骨的暴露。我們使用可靠的腓動脈穿通肢螺旋槳皮瓣來重建足跟墊。結果：在術後六個月追蹤發現，病患傷口完全癒合，沒有腳踝功能上的喪失，且行走功能也不受影響。結論：穿通枝螺旋槳皮瓣具有如下幾個優點：它們只需較短操作時間、不需要顯微血管吻合和恢復期短等優點。因此，穿通枝螺旋槳皮瓣是足跟墊重建的良好替代選擇。