Martin D, Bitonti-Grillo C, De Biscop J, Schott H, Mondie J M, Baudet J, Peri G
Department of Plastic and Reconstructive Surgery, Hôpital du Tondu, Bordeaux, France.
Br J Plast Surg. 1991 Aug-Sep;44(6):397-402. doi: 10.1016/0007-1226(91)90194-o.
The authors present a preliminary report of a new microsurgical mandibular reconstruction procedure using a segment of the internal condyle of the femur as a free vascularised bone graft. It is possible to harvest a compound flap including a bony segment measuring 8 X 1.5 X 1.5 cm and a cutaneous saphenous flap with its nutrient pedicle arising from the descending genicular artery and vein. This surgical procedure provides a good cortico-cancellous bony segment and a separate skin flap. Dissection of the flap is sometimes difficult due to the inconsistency of its vascular anatomy; the donor site is left with minimal morbidity but, because of weakening of the femur, our patients are instructed not to return to full weight-bearing before the sixth postoperative week. We consider segmental reconstruction of the mandibular body to be one of the best indications for the flap.
作者们展示了一份初步报告，介绍了一种新的显微外科下颌骨重建手术，该手术使用一段股骨内髁作为带血管蒂的游离骨移植。可以切取一个复合皮瓣，包括一个尺寸为8×1.5×1.5厘米的骨段和一个隐静脉皮瓣，其营养蒂来自膝降动脉和静脉。该手术提供了一个良好的皮质-松质骨段和一个独立的皮瓣。由于皮瓣血管解剖结构的不一致，皮瓣的解剖有时会很困难；供区的发病率极低，但由于股骨变弱，我们会告知患者在术后第六周之前不要恢复完全负重。我们认为下颌骨体部的节段性重建是该皮瓣的最佳适应证之一。
