Lim I J, Kour A K, Pho R W
Department of Surgery, National University of Singapore, Singapore.
Hand Clin. 1999 Nov;15(4):585-8, viii.
A free vascularized fibular bone transfer was successfully performed in a 1-year-old child to reconstruct the loss of the right humeral shaft following neonatal osteomyelitis. Subsequent growth of the child resulted in gross arm length discrepancy, with associated functional deficits. Callostatic distraction-lengthening of the vascularized fibular graft was carried out to compensate for this limb length discrepancy by using an Ilizarov external fixator. Lengthening of 6 cm over a 3-month period, representing a 75% increase in the original length of the transplanted fibula, was achieved. Active bone regeneration, good corticalization and endosteal medullary cavity formation was observed in the lengthened fibula. The combined modalities of vascularized bone transfer and Ilizarov callostatic distraction-lengthening offer a solution for reconstruction for large segmental bone loss associated with growth arrest of the epiphyseal plates in children.
对一名1岁儿童成功实施了带血管游离腓骨骨移植术，以重建新生儿骨髓炎后右肱骨干缺损。患儿随后的生长导致上臂长度明显不等，并伴有功能缺陷。采用伊里扎洛夫外固定器对带血管腓骨移植骨进行静力性撑开延长，以弥补肢体长度差异。在3个月的时间内实现了6厘米的延长，移植腓骨的原始长度增加了75%。在延长的腓骨中观察到活跃的骨再生、良好的皮质化和骨内膜髓腔形成。带血管骨移植和伊里扎洛夫静力性撑开延长的联合方式为儿童骨骺板生长停滞相关的大段骨缺损重建提供了一种解决方案。
