Lenze U, Pohlig F, Knebel C, Lenze F, Harrasser N, Mühlhofer H, Toepfer A, Rechl H, von Eisenhart-Rothe R
Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der TU München, Ismaningerstraße 22, 81675, München, Deutschland.
Department of Orthopaedics, The Royal Children's Hospital, Melbourne, Australien.
Orthopade. 2017 Aug;46(8):648-655. doi: 10.1007/s00132-017-3442-2.
The reconstruction of large bone defects following tumor resection, trauma or infection is difficult and subject to individual preferences of each surgeon. Free autologous fibula grafts are a reliable biological treatment method, whereas both a vascularised and a non-vascularised transplantation is possible. The use of either treatment option - vascularised or non-vascularised - is accompanied by individual advantages and/or disadvantages that should be taken into consideration during the preoperative planning process. Vascularised fibula transplants should be used especially for the reconstruction of large segmental defects and in patients, in whom adjuvant chemo- and/or radiation therapy is to be administered. Non-vascularised fibula grafts - which offer the advantage of a certain regeneration potential at the donor site as well as a shorter operation time - might be beneficial for bridging hemicortical defects and segmental defects with good soft tissue coverage.
肿瘤切除、创伤或感染后大骨缺损的重建困难,且因外科医生个人偏好而异。游离自体腓骨移植是一种可靠的生物治疗方法,血管化和非血管化移植均可。血管化或非血管化这两种治疗选择都有各自的优缺点,在术前规划过程中应予以考虑。血管化腓骨移植尤其适用于大段骨缺损的重建以及需要进行辅助化疗和/或放疗的患者。非血管化腓骨移植在供区具有一定的再生潜力且手术时间较短,可能有利于桥接半皮质骨缺损和软组织覆盖良好的节段性缺损。