| Objective :To investigate the surgical methods and clinical effects of the tendon flap of the descending genicular artery to repair the composite tissue defect in the heel of the children.Methods :From February 2003 to June 2011,10 cases of composite tissue defect of heel were repaired by tendon flap with anastomosis of descending genicular artery.There were Achilles tendon and heel soft tissue defects,and part of them had calcaneal defect at the Achilles tendon,the area of skin defect was 5cm×4cm to 8cm×7cm.9 cases were repaired with adductor magnus tendon flap based on descending genicular artery,1 cases repaired with gracilis tendon flap based on descending genicular artery.The size of the flap was from 6cm × 5cm to 9cm × 7cm.the donor sites in 9 cases were treated with full-thickness skin graft from the abdomen,and 1 case was sutured directly.Results: 1 cases occurred artery vascular crisis,and the flap survived after reoperation with embolization resection and reanastomosis,the remaining 9 flaps survived and the donor site healed in one stage.All the patients were followed up for 6 to 36 months(averaged 12 months).The appearance of the heel flap was satisfactory,the texture was fine,the shape was not bulky,the two-point discrimination was 6 to 15 mm,the ankle function was satisfactory,and the walking function of the foot was not affected.The heel lifting test was negative,the function of running,walking and jumping without limitation and recovery of daily life.The scores according to The American Ankle Surgery Association(AOFAS)ankle and foot scoring system were 86 to 100 points,with an average of 97 points.The skin graft in the donor site was soft,with good appearance and no scar contracture.Conclusion : The tendon flap of the descending genicular artery is an ideal procedure for reconstruction of the composite tissue defect in the heel of the children.It restores the heel appearance and function of children. |
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