Frohberg U, Mazock J B
Department of Oral and Maxillofacial Surgery and Pharmacology, Baylor College of Dentistry, The Texas A and M University Health Science Center, Dallas, TX 75246, USA.
Mund Kiefer Gesichtschir. 2005 Mar;9(2):63-5. doi: 10.1007/s10006-005-0602-z.
The proximal tibia has become a well-accepted donor site for autologous bone, but there are few reports of complications with its use in maxillofacial reconstruction. Our retrospective study quantifies incidence and type of complications related to the proximal tibia bone harvest.
Sixty-three surgeries performed from March 2000 to March 2004 were reviewed; 23 male and 38 female patients underwent unilateral proximal tibia metaphysis harvest. No additives were used to increase the volume of the grafts. All patients were allowed to ambulate as tolerated on the 2nd postoperative day.
All patients developed ecchymosis and edema on the donor limb, which resolved quickly. All patients reported minor gait disturbances. Complications were seen in 12 patients (19%) and included prolonged pain at the donor site and prolonged gait disturbances well beyond 2 weeks, seroma formation, paresthesia around the skin incision, bleeding, scar formation after wound breakdown, and knee joint perforation.
Harvesting bone from the proximal tibial metaphysis is a safe procedure associated with a low incidence of overall complications. However, prolonged pain and gait disturbances are to be expected in 10% of the patients.
胫骨近端已成为广泛接受的自体骨供区,但关于其在颌面重建中应用的并发症报道较少。我们的回顾性研究对与胫骨近端取骨相关的并发症发生率及类型进行了量化。
回顾了2000年3月至2004年3月期间进行的63例手术;23例男性和38例女性患者接受了单侧胫骨近端干骺端取骨。未使用添加剂来增加移植物的体积。所有患者在术后第2天可根据耐受情况行走。
所有患者供肢均出现瘀斑和水肿,且很快消退。所有患者均报告有轻微步态障碍。12例患者(19%)出现并发症,包括供区长期疼痛、超过2周的长期步态障碍、血清肿形成、皮肤切口周围感觉异常、出血、伤口裂开后瘢痕形成以及膝关节穿孔。
从胫骨近端干骺端取骨是一种安全的手术,总体并发症发生率较低。然而,预计10%的患者会出现长期疼痛和步态障碍。