目的 实践与探索足踝侧面深层组织广泛缺损且不稳定的综合修复治疗。方法 自2003-02至2012-05共收治足踝部侧面广泛深层组织缺损且不稳定患者34例。首先重建足踝关节的骨性和韧性连接稳定。创面严重的病例采用游离修薄背阔肌皮瓣。下肢血供缺失的病例采用游离健肢小腿内侧皮瓣在修复创面同时通过皮瓣的轴型动脉供血。此外，对健侧小腿内侧交腿转移岛状皮瓣等远距离转位皮瓣的蒂部进行了设计改进，构成封闭状蒂，便于固定、观察和护理。结果 34例术后随访0.5~10年，足踝关节间稳定，血运状况良好。末次随访AOFAS评分为(81.23±9.54)分，功能优良率为88.24%。结论 足踝部侧面广泛深层组织缺损并不稳定是一类严重的足踝复合损伤。应根据具体伤情，进行骨和关节连接多形式功能重建可获得运动中骨性稳定和韧性稳定，运用多种类型组织瓣，提供有效的覆盖和深层组织营养支持。

Objective To practise and study the comprehensive repair of wide deep tissue defect and instability at the side of ankle and foot. Methods 34 patients with wide deep tissue defect and instability at the side of ankle and foot were treated from 2003 February to 2012 May. First of all, the stability of bony and tenacious connection was rebuilded. Free latissimus dorsi flaps were used for the patients with serious wounds and healthy legs’ free medial flaps which were supplied with the axis-artery were used for the patients lacking blood supply to the lower limbs. Additionally, improvement of the pedicles of distant transplantation skin flaps, such as the healthy legs’ free medial skin flaps, has been made to be helpful for fixation, observation and care. Results This group of patients were followed up for half a year to ten years. Their joints of ankles and feet were stable and the blood supplies to each injured foot were in good condition. The AOFAS scale scores of the patients were (81.23±9.54) points and the excellent and good rate was 88.24% at the final follow-up time. Conclusions The injury with wide deep tissue defect and instability at the side of ankle and foot is a kind of special serious complex injury at the ankle and foot. Based on wound conditions, reconstructing connection both in the bones and in the joints is able to obtain the bony and tenacious stability in the movement, and using varied types of tissue flaps provides the cover and support for the deep tissues effectively.