摘要
目的：评价应用吻合血管自体腓骨移植修复胫骨缺损的疗效。方法：分析应用吻合血管腓骨移植修复胫骨缺损21例的资料。骨缺损长度4.5~12.0 cm,平均7.0 cm。采用自体腓骨5.5~16.0 cm,平均11.0 cm。12例同时行自体髂骨植骨。以外固定架、钢板螺钉或螺钉结合石膏托固定。结果：全部患者获得2年11个月（平均）随访,伤口均Ⅰ期愈合,除1例外皮瓣均成活,无血管危象发生。X线片示术后4~8个月移植腓骨与受体骨愈合,愈合时间6.6个月（平均）。患肢开始部分负重时间为术后4~8个月。1例移植骨于术后1年因完全负重而骨折。自体腓骨联合髂骨移植者术后10个月至2年患肢完全负重,单用自体腓骨移植者术后1.5~3年患肢完全负重,均无移植骨骨折。结论：吻合血管自体腓骨移植修复胫骨缺损具有骨愈合可靠、并发症少的优点,联合自体髂骨植骨可促进移植骨增粗塑形,早日恢复负重功能。
Objective：To evaluate the effect of repairing tibial defects with free vascularized fibula autograft.Methods：16 tibial defects treated with free vascularized fibula autograft from August 1999 to October 2007 were retrospectively reviewed.There were 14 male and 2 female with average age of 35.4 Y.Tibial defects were non-union of traumatic-infectious in 10 cases,opened comminuted fracture with massive bone defects in 3 cases,fibrous dysplasia in 1 case and congenital pseudoarthrosis in 2 cases.The length of bone defects were 4.5 to 12.0 cm（7.0 cm on average）,and of free vascularized fibula 5.5 to 16.0 cm.7 cases of which were ilium autograft.The way of fixation were external fixator,plate or screw with plaster.Results：The patients were followed up with an average of 2 years and 10 months（7 months to 8 years）.Wounds were healed at Ⅰ stage,and flaps were alive without vascular crisis except one.The radiographic evidence showed union 4 to 8 months（6.6 months on average）,and it is the time of part weight loading.A graft was fracture one year after operation because of full weight loading.The time of full weight loading was 10 months to 2 years in free vascularized fibula autograft compounding ilium autograft,1 year and 6 months to 3 years in free vascularized fibula autograft alone without fracture. Conclusion：Free vascularized fibula autograft is union solid and less complication to repair of tibial defects.,and it compounding ilium autograft can permit early functional rehabilitation because of promoting graft thick and shape.
出处
《现代临床医学》
2011年第1期53-54,共2页
Journal of Modern Clinical Medicine
关键词
腓骨
骨缺损
修复
骨移植
febula
bone defect
repair
bone graft
