Teot L, Souyris F, Bosse J P
Plastic and Reconstructive Surgery Department, Hopital Lapeyronie, Montpellier, France.
Ann Plast Surg. 1992 Oct;29(4):332-40. doi: 10.1097/00000637-199210000-00010.
Congenital segmental amputations are difficult to correct. Free interposition bone grafts with growth centers were tried experimentally by many investigators even at the beginning of this century. Attempts at clinical application of this principle, however, were mostly failures. More recently, with the advent of microsurgical techniques, new hope has arisen. In particular, toe transfers in children have confirmed the survival of such growth centers, as these transfers could be found to grow normally [1]. The transfer of vascularized epiphysis with its growth plate has been shown in animal limbs to achieve a rate of growth comparable with the normal site. Originally, two donor sites were used with acceptable results in children. These were the superior epiphysis of the fibula and the iliac crest. So far, in most clinical applications, they have been used as appositional transfers. However, a growth problem occurring at the donor site has proved to be quite crippling.
先天性节段性截肢很难矫正。早在本世纪初，许多研究者就尝试通过植入带有生长中心的游离骨移植进行实验。然而，将这一原理应用于临床的尝试大多以失败告终。近年来，随着显微外科技术的出现，新的希望出现了。特别是儿童的足趾移植证实了此类生长中心能够存活，因为这些移植的足趾能够正常生长[1]。在动物肢体上，带生长板的带血管骨骺移植已被证明能达到与正常部位相当的生长速度。最初，有两个供区用于儿童，效果尚可。这两个供区分别是腓骨上端骨骺和髂嵴。到目前为止，在大多数临床应用中，它们都被用作贴附移植。然而，供区出现的生长问题已被证明相当严重。
