Adani Roberto, Delcroix Luca, Tarallo Luigi, Baccarani Alessio, Innocenti Marco
Department of Orthopaedic Surgery, University of Modena and Reggio Emilia, Modena, Itlay.
J Shoulder Elbow Surg. 2008 Jul-Aug;17(4):578-84. doi: 10.1016/j.jse.2007.12.011. Epub 2008 Apr 18.
Humeral nonunions still present a challenge to the orthopedic surgeon. Many methods of treating recalcitrant, posttraumatic humeral shaft nonunions have been described, with varying degrees of success. The present report reviews our experience with the use of vascularized fibular grafting for the treatment of large humeral defects. We treated 13 patients, with an average length of the humeral defect of 10.5 cm. Nine patients healed primarily, 3 required additional bone grafting, and 1 had a second fibular transplant. The mean period to radiographic bone union was 6 months. Only 5 patients regained full range of motion of the shoulder and elbow. The vascularized fibular graft is a reliable reconstructive procedure for recalcitrant pseudoarthrosis of the humerus in which the bony gap is greater than 6 to 7 cm, especially when traditional procedures have not provided the expected result.
肱骨骨不连仍然是骨科医生面临的一项挑战。已经描述了许多治疗顽固性创伤后肱骨干骨不连的方法，成功率各不相同。本报告回顾了我们使用带血管腓骨移植治疗大段肱骨缺损的经验。我们治疗了13例患者，肱骨缺损平均长度为10.5厘米。9例患者一期愈合，3例需要额外植骨，1例进行了第二次腓骨移植。影像学骨愈合的平均时间为6个月。只有5例患者恢复了肩和肘的全范围活动。带血管腓骨移植是治疗肱骨顽固性假关节的可靠重建方法，适用于骨缺损大于6至7厘米的情况，尤其是在传统方法未取得预期效果时。
