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游离非血管化腓骨支撑骨移植治疗创伤后下肢大段骨缺损

Free non-vascularized fibular strut bone graft for treatment of post-traumatic lower extremity large bone loss.

作者信息

Lin Kai-Cheng, Tarng Yih-Wen, Hsu Chien-Jen, Renn Jenn-Huei

机构信息

Department of Orthopaedic Surgery, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 813, Taiwan.

出版信息

Eur J Orthop Surg Traumatol. 2014 May;24(4):599-605. doi: 10.1007/s00590-013-1342-7. Epub 2013 Oct 25.

Abstract

Post-traumatic large bone defects of more than 4 cm occur sometimes in open lower extremity fractures. Management of this kind trauma can be a challenge to orthopedic surgeons. We have managed this kind of bone defect by the use of free non-vascularized fibular strut bone grafts (FNVFG) harvested subperiosteally and held by screw fixation of the strut ends to the ends of the bone defect. Ten patients, eight males and two females, with a mean age of 44 years (range 26-76 years) underwent this procedure. The length of defect was 7.0 cm on average (ranging from 4 to 8 cm). Ten grafts (100%) united at both ends within an average of 6 months (range 5-9 months). Nine patients walked independently, and one patient walked with a stick. FNVFG is a simple procedure and a reliable method to bridge huge bone loss due to open fractures of lower extremities successfully in selected cases.

摘要

开放性下肢骨折有时会出现超过4厘米的创伤后大骨缺损。这类创伤的处理对骨科医生而言可能是一项挑战。我们通过使用经骨膜下采集的游离非带血管腓骨支撑骨移植(FNVFG)来处理这类骨缺损,将支撑骨两端用螺钉固定于骨缺损两端。10例患者接受了该手术,其中男性8例,女性2例,平均年龄44岁(范围26 - 76岁)。缺损长度平均为7.0厘米(范围4至8厘米)。10块移植骨(100%)两端平均在6个月内(范围5 - 9个月)愈合。9例患者可独立行走,1例患者需借助拐杖行走。FNVFG是一种简单的手术方法,在特定病例中是成功修复因下肢开放性骨折导致的巨大骨缺损的可靠方法。

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