Santanelli di Pompeo Fabio, Selvaggi Gennaro, Longo Benedetto, Laporta Rosaria, Amorosi Vittoria, Sorotos Michail
Plastic Surgery Department, Sant'Andrea Hospital, School of Medicine and Psychology, "Sapienza" University of Rome, Rome, Italy.
Department of Plastic and Reconstructive Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Microsurgery. 2018 Jul;38(5):572-575. doi: 10.1002/micr.30303. Epub 2018 Feb 8.
We present a case report of a 10-year-old girl diagnosed with Ewing sarcoma treated with intra-articular wide resection of the right femur and reconstruction with a series-connected double-barrel bilateral vascularized fibula graft (db-BVFG), including fibular head for articulation with the acetabulum of the pelvic bone and preservation of the epiphyseal growth plates for eventual limb growth. No postoperative complications were observed and bone union was achieved with fibular graft hypertrophy, allowing for full weight bearing. Neither local recurrence nor metastasis was observed at 17-year follow-up. Range of motion degrees at last follow up: hip flexion 90 degree, extension 12 degree, abduction 31 degree, rotation 25 degree. Right versus left limb discrepancy was 60 mm. Db-BVFG may be an option for reconstruction of long femoral defects and hip joint restoration following tumor resection and inclusion of epiphysis within the graft is a viable option in pediatric patients to restore longitudinal growth of the reconstructed long bone.
我们报告了一例10岁女孩的病例，该女孩被诊断为尤因肉瘤，接受了右股骨关节内广泛切除，并采用串联双管双侧带血管腓骨移植（db-BVFG）进行重建，包括用于与骨盆髋臼连接的腓骨头，并保留骨骺生长板以促进肢体最终生长。术后未观察到并发症，腓骨移植肥大实现了骨愈合，允许完全负重。17年随访时未观察到局部复发或转移。最后一次随访时的活动度：髋关节屈曲90度，伸展12度，外展31度，旋转25度。右下肢与左下肢相差60毫米。Db-BVFG可能是重建股骨长段缺损和肿瘤切除后髋关节修复的一种选择，在移植中纳入骨骺对于恢复重建长骨的纵向生长在儿科患者中是一种可行的选择。
