使用大块同种异体骨联合手术血管生成重建大面积骨缺损：一例报告
Reconstruction of Extended Bone Defects Using Massive Allografts Combined with Surgical Angiogenesis: A Case Report.
作者信息
Struckmann Victoria, Schmidmaier Gerhard, Ferbert Thomas, Kneser Ulrich, Kremer Thomas
机构信息
Department of Hand, Plastic and Reconstructive Surgery, Hand and Plastic Surgery, BG Trauma Center Ludwigshafen, Burn Center, Ludwigshafen, Rheinland-Pfalz, Germany.
Department of Orthopaedics and Traumatology, University of Heidelberg, Heidelberg, Germany.
出版信息
JBJS Case Connect. 2017 Jan-Mar;7(1):e10. doi: 10.2106/JBJS.CC.16.00098.
CASE
A 20-year-old patient presented with an extended composite knee defect with destruction of the medial femoral condyle, including the medial collateral ligament. Treatment included using an anterolateral thigh flap for soft-tissue reconstruction, tensor fasciae latae muscle for ligament repair, and a massive allogenic bone graft of the medial femoral condyle that was revascularized with an osteocutaneous composite free flap from the contralateral femur. At 17 months postoperatively, the outcome was evaluated with scores on several established scales and radiographic assessment.
CONCLUSION
The combination of vascularized soft-tissue reconstruction and osseous reconstruction using allogenic bone along with surgical angiogenesis proved to be effective. Complex extremity reconstruction should be discussed with interdisciplinary specialists.
病例
一名20岁患者出现膝关节复合性缺损扩大，伴有股骨内侧髁破坏，包括内侧副韧带。治疗方法包括使用股前外侧皮瓣进行软组织重建，阔筋膜张肌用于韧带修复，以及采用来自对侧股骨的骨皮复合游离皮瓣对股骨内侧髁的大块同种异体骨移植进行血管重建。术后17个月，通过几个既定量表的评分和影像学评估对结果进行了评估。
结论
血管化软组织重建、同种异体骨骨重建以及手术血管生成的联合应用被证明是有效的。复杂肢体重建应与多学科专家进行讨论。
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