Cherubino Mario, Ronga Mario, Sallam Davide, Fagetti Alessandro, Valdatta Luigi, Cherubino Paolo
Division of Plastic and Reconstructive Surgery (M.C., D.S.) and Division of Orthopedics and Traumatology (M.R., A.F., P.C.), Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy.
Plast Reconstr Surg Glob Open. 2016 Dec 14;4(12):e1149. doi: 10.1097/GOX.0000000000001149. eCollection 2016 Dec.
The management of nonunion of the forearm bones is a challenging task. Multiple factors have been associated with the establishment of forearm nonunion, such as the fracture position and complexity, general condition of the patient, and the previously utilized surgical technique. The optimal surgical treatment of a bone gap remains a subject of discussion. Autogenous corticocancellous bone grafts and vascularized bone flaps have been used with differing results. The authors describe a technique for the treatment of posttraumatic nonunion of the radius with a 5-cm bone gap using the free anterolateral thigh fascial flap wrapped around a tricortical iliac bone graft. The fracture healed after 5 weeks. The use of a vascularized tissue wrapped around the bone graft resulted in a well-healed bone and no signs of resorption after 2 years of follow-up. A bone graft wrapped by a fascial flap could magnify the restorative effect on the bone defect because of its dual role of constructing vascularization and inducing tissue regeneration.
前臂骨不连的治疗是一项具有挑战性的任务。多种因素与前臂骨不连的形成有关，如骨折位置和复杂性、患者的一般状况以及先前采用的手术技术。骨缺损的最佳手术治疗方法仍是一个讨论的话题。自体皮质松质骨移植和带血管骨瓣的使用效果各异。作者描述了一种使用游离股前外侧筋膜瓣包裹三皮质髂骨移植治疗桡骨创伤后骨不连且骨缺损达5厘米的技术。骨折在5周后愈合。在2年的随访中，使用带血管组织包裹骨移植导致骨愈合良好且无吸收迹象。由于筋膜瓣在构建血管化和诱导组织再生方面的双重作用，其包裹的骨移植可增强对骨缺损的修复效果。
