Kamei Y, Aoyama H, Yokoo K, Hayashi Y, Fujii K, Kondo C, Sato Y
Department of Plastic and Reconstructive Surgery, Aichi Medical University, Nagoya, Japan.
Ann Plast Surg. 2001 Oct;47(4):450-2. doi: 10.1097/00000637-200110000-00017.
The authors report a case of a free fibular graft that was successful as a result of venous return delivered through the bone marrow. A 26-year-old man underwent reconstruction of the left tibia and a soft-tissue defect of the lower leg. A free vascularized fibular bone and skin flap was elevated. The fibular vessels were anastomosed to the dorsalis pedis vessels. The elevated fibular bone was fixed to the tibia. The next day, reanastomosis was necessary because of venous thrombosis. However, the fibular vein rethrombosed, but blood flow was ascertained by Doppler flowmetry, with darker blood flow being recognized from the edge of the flap. Four days after surgery, the skin color gradually improved, and the flap had almost completely taken. On retrospective evaluation, the authors concluded that this flap succeeded because venous return was routed through the bone marrow in the free fibular graft.
作者报告了一例游离腓骨移植成功的病例，其成功归因于通过骨髓实现的静脉回流。一名26岁男性接受了左胫骨重建及小腿软组织缺损修复手术。掀起了一个带血管蒂的游离腓骨骨皮瓣。将腓骨血管与足背血管进行了吻合。将掀起的腓骨固定于胫骨。次日，因静脉血栓形成需要再次吻合。然而，腓骨静脉再次形成血栓，但通过多普勒血流仪确定有血流，且从皮瓣边缘可识别出较暗的血流。术后4天，皮肤颜色逐渐改善，皮瓣几乎完全成活。经回顾性评估，作者得出结论，该皮瓣成功是因为游离腓骨移植中的静脉回流是通过骨髓进行的。
