用先前骨折的腓骨重建胫骨缺损，包括将骨折段作为游离骨膜皮肤瓣。
Reconstruction of a tibial defect with a previously fractured fibula including the fractured segment as a free osteoseptocutaneous flap.
作者信息
Sadek Ahmed Fathy, Halim Ahmad Sukari, Ismail Faisham Wan, Imran Yusof M
机构信息
From the *Orthopedic Surgery Department, El-Minia University Hospital, El Minia, Egypt; †Reconstructive Sciences Unit, and ‡Orthopedic Department, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
出版信息
Ann Plast Surg. 2014 Oct;73(4):402-4. doi: 10.1097/SAP.0b013e31827fb387.
INTRODUCTION
Reconstruction of major bone defects using free fibular transfer provides a good biological option in unsound situations. Most authors recommend selection of the recipient blood vessels outside the zone of injury to achieve successful free fibular transfer. Occasionally, in polytraumatized patients, the surgeon has to use a previously fractured fibula as a graft, with increased risk of inclusion of the injury zone that may lead to failure.
METHODS
We report a rare case of successful reconstruction of a large tibial defect using a previously fractured fibula as a free osteoseptocutaneous flap. The innovative point in our case is the inclusion of the fracture site within the utilized segment, which to our knowledge has never been reported.
CONCLUSIONS
As long as the microsurgical principles are adhered to, the effect of the zone of injury on the graft viability should not be overwhelming.
引言
在不利情况下，使用游离腓骨移植重建大的骨缺损提供了一种良好的生物学选择。大多数作者建议在损伤区域外选择受区血管，以实现游离腓骨移植的成功。偶尔，在多发伤患者中，外科医生不得不使用先前骨折的腓骨作为移植物，这增加了包含损伤区域的风险，可能导致手术失败。
方法
我们报告了一例罕见的成功病例，使用先前骨折的腓骨作为游离骨膜皮瓣成功重建了大的胫骨缺损。我们病例的创新点是将骨折部位包含在所使用的节段内，据我们所知，这从未有过报道。
结论
只要坚持显微外科原则，损伤区域对移植物存活的影响不应是压倒性的。
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