Gan Aaron W T, Puhaindran Mark E, Pho Robert W H
Department of Hand & Reconstructive Microsurgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore.
Department of Hand & Reconstructive Microsurgery, National University Hospital, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore 119228, Singapore.
Injury. 2013 Mar;44(3):313-7. doi: 10.1016/j.injury.2013.01.014. Epub 2013 Jan 20.
Large bone defects in the upper limb pose many challenges in reconstructive surgery. Conventional and innovative methods have been described, employing the use of microsurgical and non-microsurgical techniques to overcome both bony and soft tissue defects. This article reviews the success and pitfalls of different techniques of reconstruction of large bone defects in the upper limb, including microsurgical transfer of the free vascularised fibula graft as a diaphyseal bone replacement and as a hemivascularised joint transplant, and non-microsurgical options using conventional bone grafting, the induced membrane technique and the role of callotatic distraction-lengthening procedures.
上肢的大骨缺损在重建手术中带来诸多挑战。已有传统和创新方法的相关描述，这些方法采用显微外科和非显微外科技术来克服骨与软组织缺损。本文综述了上肢大骨缺损不同重建技术的成功之处与不足之处，包括游离带血管腓骨移植作为骨干替代物的显微外科移植以及作为半血管化关节移植，还有使用传统骨移植、诱导膜技术以及骨痂延长牵张成骨术的非显微外科选择。
