Effect Comparison of Sural Nerve Nutrient Vascular Pedicle Flap and Medial Plantar Flap in Repairing Heel Soft Tissue Defects
Objective To explore the effect of sural nerve nutrient vascular pedicle flap and medial plantar flap in repairing heel soft tissue defects.Methods 89 patients with heel soft tissue defects in the author's hospital were prospectively selected from August 2018 to March 2022,and were divided into group A(n=45)and group B(n=44)according to the random number table method.Sural nerve nutrient vascular pedicle flap was used for repair in group A,and medial plantar flap was used in group B.The surgical conditions,affected foot function,sensory recovery and satisfaction of skin flap appearance were compared between both groups.Results The time of skin flap removal transplantation in group B was shorter than that in group A,and the intraoperative blood loss was less than that in group A(P<0.05).The complete survival rate of skin flap was higher in group B than that in group A(P<0.05).At 3 months after surgery,the American Orthopedic Foot and Ankle Society(AOFAS)ankle-hindfoot score in both groups was significantly enhanced compared with that before surgery,and the AOFAS score in group B was higher than that in group A(P<0.05).The British Medical Research Council(BMRC)sensory function grading in the two groups of patients with complete skin flap survival was grade S2 and above,and the BMRC sensory function grading was better in group B compared to group A(P<0.05).score of skin flap appearance satisfaction in group A was lower than that in group B(P<0.05).Conclusion Medial plantar flap is more effective in repairing heel soft tissue defects with wound diameter≤8.0 cm compared with sural nerve nutrient vascular pedicle flap transplantation.It not only has a higher survival rate of skin flap,but also has better joint function and sensory recovery of affected foot,and it has shorter surgical time and less intraoperative blood loss.