Chen H C, Tang Y B, Noordhoff M S
Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Surgery. 1991 Nov;110(5):854-9.
Intraosseous infusion of fluid had been used in traumatology. Here we describe a clinical situation in which bone marrow is first used for drainage of venous blood in a free osteocutaneous flap. Two factors account for the survival of the large osteocutaneous flap in which venous anastomosis was impossible. (1) In the design of the arterial circuit and the major route of venous drainage, there were two ends of the peroneal artery of the osteocutaneous flap. Both its upper and lower ends were anastomosed to the anterior tibial artery of the recipient site to constitute an uninterrupted arterial circulation. This prevented stagnation of arterial flow and thrombosis of the arterial anastomosis. (2) The major route of venous drainage was through bone marrow. The initial congestion was finally overcome by the development of neovascularization. Bone scan showed good survival of bone with increased uptake of radioactivity. At 3 years follow-up, roentgenogram showed bone union, and the patient had no trouble walking. The continuity of the anterior tibial artery, which had been interrupted by trauma, was restored by this flap.
骨内输液已应用于创伤学领域。在此，我们描述一种临床情况，即在游离骨皮瓣中首次将骨髓用于引流静脉血。有两个因素促成了无法进行静脉吻合的大型骨皮瓣的存活。（1）在动脉循环设计和静脉引流主要路径方面，骨皮瓣的腓动脉有两端。其上下两端均与受区的胫前动脉吻合，构成不间断的动脉循环。这防止了动脉血流停滞和动脉吻合处血栓形成。（2）静脉引流的主要路径是通过骨髓。最初的充血最终通过新生血管形成得以克服。骨扫描显示骨存活良好，放射性摄取增加。随访3年时，X线片显示骨愈合，患者行走无困难。该皮瓣恢复了因创伤而中断的胫前动脉的连续性。
