Saint-Cyr Michel, Farkas Jordan, Gupta Amit
Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9132, USA.
J Reconstr Microsurg. 2008 Nov;24(8):583-7. doi: 10.1055/s-0028-1090603. Epub 2008 Oct 16.
Free vascularized bone transfer is a viable treatment option for extensive bony defects greater than 6 to 8 cm involving scarred, poorly vascularized, or infected recipient beds, such as in chronically infected nonunion of the radius and ulna treated with a double-barrel free fibula flap. Both patients reported here experienced bony union with significant resolution of their symptoms. Although range of motion improved following an aggressive physical therapy regimen, pronation was adversely affected. Chronic infected nonunions or nonunions from radionecrosis involving large segmental defects of both forearm bones are a truly unique challenge and must be treated aggressively to ensure any useful long term function of the injured limb.
带血管蒂游离骨移植是治疗超过6至8厘米的广泛性骨缺损的一种可行治疗选择，这些骨缺损涉及瘢痕化、血运不良或感染的受区床，例如在用双筒游离腓骨瓣治疗的桡骨和尺骨慢性感染不愈合中。这里报告的两名患者均实现了骨愈合，症状得到显著缓解。尽管在积极的物理治疗方案后活动范围有所改善，但旋前功能受到了不利影响。涉及双侧前臂骨大段缺损的慢性感染性骨不连或放射性坏死导致的骨不连是一个真正独特的挑战，必须积极治疗以确保受伤肢体的任何有用的长期功能。
