Analysis on perforating vessel propeller flap used in soft tissue repair of heel in 30 children
Objective To investigate the therapeutic effect of perforating vessel propeller flap used in soft tissue defect repair of heel spoke injury in children.Methods Clinical data,treatment process,and efficacy indicators of 30 children(18 males,12 females,aged 4~14 years,average 8.3 years,with skin and soft tissue defect area of 2.0cm × 3.5cm~4.0cm × 7.5cm)admitted to the Qujing Municipal First Hospital from January 2020 to December 2022 were consecutive selected.Preoperative vascular contrast-enhanced ultrasound was used to examine and label the perforating vessel of the lower leg.17 cases were repaired with posterior tibial artery perforating vessel propeller flap and 13 cases were repaired with peroneal artery perforating vessel propeller flap.The wound healing was observed regularly after surgery.Visual analogue scale(VAS)and the ankle and posterior foot scores of the American Orthopaedic Foot and Ankle Association(AOFAS)score were completed before surgery and at the last follow-up.Results 30 patients were followed up for 6 to 24 months,with an average of 15.6 months.The other flaps survived except 2 cases having distal partial necrosis.The flap had no infection,good color and texture,and the wound healed in stage 1.At the last follow-up,ankle pain and function were significantly improved,the average VAS score decreased from 5.33±0.19 before surgery to 1.50±0.09 at the last follow-up(P<0.001).The average AOFAS score increased from 46.83±1.13 before surgery to 92.27±0.58 at the last follow-up(P<0.001).Conclusions The application of perforating vessel propeller flap to repair soft tissue defect of heel spoke injury in children is safe,efficient and worthy of promotion.