摘要目的:探讨不携带一级源血管的游离股前外侧穿支皮瓣修复儿童足跟部轮辐伤所致皮肤软组织缺损的临床疗效。方法:自2013年1月至2019年6月，经术前彩色多普勒超声(CDS)定位，对10例儿童足跟部轮辐伤所致的皮肤软组织缺损，应用不携带一级源血管的游离股前外侧穿支皮瓣修复，并一期皮瓣去脂。其中Ⅰ级轮辐伤3例，Ⅱ级轮辐伤5例，Ⅲ级轮辐伤2例，皮瓣面积4 cm×8 cm～5 cm×13 cm，供区均直接缝合。结果:10例皮瓣均完全存活，术后无血管危象、皮瓣坏死等情况发生，1例创面愈合不良通过换药后愈合。所有患儿均随访6～37个月，平均15.3个月，2例因皮瓣臃肿、中度瘢痕增生于术后半年行皮瓣修整手术。末次随访受区3例出现轻度瘢痕增生。采用美国足踝外科协会(AOFAS)踝-后足功能评分评价踝关节功能优8例、良2例，感觉恢复至S 3＋ 3例、S 3 5例、S 2 2例。 结论:不携带一级源血管的游离股前外侧穿支皮瓣修复儿童足跟部轮辐伤创面手术安全有效，能有效缩短皮瓣切取时间并降低供区并发症，具有血供可靠、供受区损伤小、疗效显著等优点，适合临床推广。

abstractsObjective:To explore the clinical efficacy of free anterolateral femoral perforator flap without primary source vessels for repair of heel spoke injury in children.Methods:From January 2013 to June 2019, 10 cases of skin and soft tissue defects caused by heel spoke injury in children were repaired by free anterolateral femoral perforator flap without primary source vessels by preoperative localization using color Doppler ultrasound (CDS), and one-stage skin flap was degreased. Among them, there were 3 cases of grade Ⅰ spoke injury, 5 cases of grade Ⅱ spoke injury, 2 cases of grade Ⅲ spoke injury. The flap area was 4 cm×8 cm to 5 cm×13 cm, and the donor site was directly sutured.Results:All the flaps survived completely. No vascular crisis and necrosis occurred after the operation, and 1 case with poor wound healing was healed after dressing change. All the patients were follow-up for 6 to 37 months, with an average of 15.3 months. 2 cases underwent flap repair half a year after operation because of bulky appearance and moderate scar hyperplasia. In the last follow-up, 3 cases had mild scar hyperplasia. According to the ankle posterior foot function score of the American Orthopedic Association of Foot and Ankle Surgeons (AOFAS), the ankle joint function was excellent in 8 cases and good in 2 cases. The sensory function recovered to S 3+ in 3 cases, S 3 in 5 cases and S 2 in 2 cases. Conclusion:The free anterolateral femoral perforator flap without primary source vessels is safe and effective in the repair of the wounds caused by the heel spoke injury in children. It can effectively shorten the time of skin flap excision and reduce the complications in the donor site. It has the advantages of reliable blood supply, small injury in the donor and recipient sites and significant effect. It is suitable for clinical application.