Pediatric Hand Surgery and Microsurgery, Orthopaedic Surgery Department, Hospital Universitari Vall 'Hebron, Universitat Autònoma de Barcelona, Institut de Recerca (VHIR), Barcelona, Spain.
Microsurgery. 2012 Jul;32(5):397-400. doi: 10.1002/micr.21985. Epub 2012 Mar 31.
The vascularized fibular periosteal flap has been recently described and showed solid angio and osteogenic features. We report the use of a free vascularized fibular periosteal transplant in the treatment of a El-Rosasy-Paley Type III congenital pseudarthrosis of the tibia in a 7-year-old boy, with a prior unsuccessful surgery at the age of three. The contralateral fibular periosteum was used to replace two-thirds of the hamartomatous tibial periosteum. We did not proceed to debriding the focus of the pseudarthrosis nor addressed the tibial recurvatum or revised the previous tibial rod. Consolidation was achieved radiologically at 3 months, allowing for the tibial rod to be removed. One year postoperatively, the patient ambulated without the use of a protective orthesis and resumed his sports practice. This novel pathogenesis-based technique showed promising results and a prompt healing of such a difficult orthopedic condition.
带血管腓骨骨膜瓣最近被描述，并显示出稳定的血管生成和成骨特性。我们报告了在一名 7 岁男孩中使用游离带血管腓骨骨膜移植治疗 El-Rosasy-Paley Ⅲ型先天性胫骨假关节的病例，该男孩在 3 岁时曾进行过一次不成功的手术。对侧腓骨骨膜被用来替代三分之二的错构性胫骨骨膜。我们没有对假关节的病灶进行清创，也没有处理胫骨后倾或修改之前的胫骨杆。3 个月时影像学上实现了骨愈合，随后取出胫骨杆。术后 1 年，患者无需使用保护支具即可行走，并恢复了运动训练。这种基于新发病机制的技术显示出了有前景的结果，能够迅速治愈这种困难的骨科病症。
