Soldado Francisco, Knörr Jorge, Haddad Sleiman, Corona Pablo S, Barrera-Ochoa Sergi, Collado Diego, Mascarenhas Vasco V, de Gauzy Jerome Sales
Department of Pediatric Upper Extremity Surgery and Microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Spain.
Microsurgery. 2015 Mar;35(3):239-43. doi: 10.1002/micr.22342. Epub 2014 Oct 18.
Bone nonunion in the pediatric population usually occurs in the context of highly unfavorable biological conditions. Recently, the vascularized fibular periosteal flap has been reported as a very effective procedure for treating this condition. Even though a vascularized tibial periosteal graft (VTPG) was described long ago and has been successfully employed in one adult case, there has been no other report published on the use of this technique. We report on the use of VTPG, pedicled in the anterior tibial vessels, for the treatment of two complex pediatric bone nonunion case: a recalcitrant supracondylar femoral pseudarthrosis secondary to an infection in an 11-year-old girl, and a tibial nonunion secondary to a failed bone defect reconstruction in a 12-year-old girl. Rapid healing was obtained in both cases. In the light of the data presented, we consider VTPG as a valuable surgical option for the treatment of complex bone nonunions in children.
小儿骨不连通常发生在生物学条件极为不利的情况下。最近，有报道称带血管蒂的腓骨骨膜瓣是治疗这种情况的一种非常有效的方法。尽管带血管蒂的胫骨骨膜移植术（VTPG）早在很久以前就已被描述，并且已成功应用于1例成人病例，但关于该技术的使用尚未有其他报道发表。我们报告了使用以胫前血管为蒂的VTPG治疗2例小儿复杂骨不连病例：1例为11岁女孩因感染导致的股骨髁上顽固性假关节，另1例为12岁女孩因骨缺损重建失败导致的胫骨骨不连。两例均获得了快速愈合。根据所提供的数据，我们认为VTPG是治疗儿童复杂骨不连的一种有价值的手术选择。
