Edmonds J L, Bowers K W, Toby E B, Jayaraman G, Girod D A
Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City 66160-7380, USA.
Otolaryngol Head Neck Surg. 2000 Oct;123(4):400-8. doi: 10.1067/mhn.2000.109474.
The osteocutaneous radial forearm free flap (OCRFFF) has not gained widespread popularity in mandibular reconstruction, primarily because of concerns about pathologic fracture of the weakened radius. This study examines the effectiveness of plate fixation of the radius bone after harvest of the OCRFFF as a mechanism to minimize donor-site morbidity and increase the usefulness of the OCRFFF. Matched pairs of fresh human cadaveric radius bones were used in this study. Two study groups were designed. The first group was used to define the amount of strength lost after a typical bone graft harvest. The second group was designed to demonstrate how much torsional strength was regained by the application of an orthopedic reconstruction plate. Statistically significant results were obtained for both groups. In group 1, the strength of the cut bones compared with that of the unaltered bones was significantly decreased by 82% (P = 0.016). In group 2, the cut bones reinforced with a plate were 75% stronger (P = 0.002) than the bones that were only cut. Although the radius bone is significantly weakened by the harvest of a graft, much of this strength can be regained with plate fixation of the radius.
桡骨前臂骨皮游离瓣（OCRFFF）在下颌骨重建中并未得到广泛应用，主要是因为担心取骨后桡骨发生病理性骨折。本研究探讨了切取OCRFFF后对桡骨进行钢板固定，以此作为一种减少供区并发症并提高OCRFFF实用性的方法的有效性。本研究使用了配对的新鲜人类尸体桡骨。设计了两个研究组。第一组用于确定典型的骨移植术后桡骨强度损失的程度。第二组旨在证明应用骨科重建钢板后桡骨恢复了多少抗扭强度。两组均获得了具有统计学意义的结果。在第一组中，与未处理的桡骨相比，取骨后的桡骨强度显著降低了82%（P = 0.016）。在第二组中，用钢板加固后的取骨桡骨比仅进行取骨的桡骨强度高75%（P = 0.002）。虽然取骨会使桡骨强度显著减弱，但通过对桡骨进行钢板固定，其大部分强度可以恢复。
