Chen Shih-Hao, Wong To, Yeh Ming-Chung, Pai Chun-Huang, Ko Jih-Yang
Department of Orthopedics, Kaohsiung Municipal Hospital, No,976, Jhonghua 1st Rd,, Gushan Dist,, Kaohsiung City 804, Taiwan.
J Med Case Rep. 2013 May 28;7:136. doi: 10.1186/1752-1947-7-136.
Free vascularized fibular grafts have been widely used for the reconstruction of long bone defects. However, the use of a vascularized tibial graft is precluded by its weight-bearing function and unacceptable donor site morbidity.
We present a rare case of using a vascularized tibia-fibular composite graft taken from a 6-year-old Chinese boy's ipsilateral lower leg to reconstruct a large bony defect of his traumatic femur. Hypertrophy of the tibial graft, good remodeling of the femoral shaft, and atrophy of the unloaded fibular graft were noted at the 10-year follow up. He was able to participate in outdoor activities such as basketball while wearing his prosthesis.
The 10-year follow up demonstrates the feasibility of this salvage procedure for a floating knee injury with neurovascular compromise.
带血管游离腓骨移植已广泛用于长骨缺损的重建。然而，由于胫骨的负重功能及其供区并发症难以接受，带血管胫骨移植的应用受到限制。
我们报告了1例罕见病例，取自一名6岁中国男孩同侧小腿的带血管胫腓骨复合移植用于重建其创伤性股骨的大骨缺损。在10年随访时，发现胫骨移植肥大、股骨干重塑良好以及未负重的腓骨移植萎缩。他在佩戴假肢的情况下能够参加篮球等户外活动。
10年随访证明了这种挽救手术用于伴有神经血管损伤的浮动膝损伤的可行性。
