利用异位骨化作为自体骨移植治疗伴有骨缺损的胫骨骨不连：文献综述与病例报告
Treatment of tibial nonunion with bone defect using a heterotopic ossification as autologous bone graft: literature overview and case report.
作者信息
Schlumberger Michael, Mayr Raul, Koidl Christian, Eichinger Martin, Roth Tobias
机构信息
Department of Trauma Surgery, University Hospital Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
出版信息
Eur J Orthop Surg Traumatol. 2018 May;28(4):741-746. doi: 10.1007/s00590-018-2146-6. Epub 2018 Feb 9.
INTRODUCTION
Nonunion after open fracture of the lower leg is a frequent complication with a prevalence of up to 40%. In cases with major bone defects, revision of the osteosynthesis with bone grafting is commonly performed. Until today, there is no report on treatment of a tibial nonunion with transplantation of a heterotopic ossification.
PRESENTATION OF CASE
We present a case of a 27-year-old male patient, who suffered from a paragliding accident with major injuries. An open fracture of the lower leg (Gustilo-Anderson IIIB) was initially treated with external fixation and vacuum-assisted closure, followed by reamed intramedullary nailing. The tibia resulted in a bone defect situation with nonunion. It was successfully treated with revision, fibular osteotomy and transplantation of a heterotopic ossification, harvested from the ipsilateral hip.
CONCLUSION
In special cases, autologous transplantation of a mature heterotopic ossification is an attractive bone graft option in treating nonunion defects.
引言
小腿开放性骨折后的骨不连是一种常见并发症，发生率高达40%。在存在严重骨缺损的情况下，通常会进行带骨移植的接骨术翻修。直到如今，尚无关于采用异位骨化移植治疗胫骨骨不连的报道。
病例介绍
我们报告一例27岁男性患者，他因滑翔伞事故而受重伤。小腿开放性骨折（ Gustilo-Anderson IIIB型）最初采用外固定和负压封闭引流治疗，随后进行扩髓髓内钉固定。胫骨出现骨缺损及骨不连情况。通过翻修、腓骨截骨术以及取自同侧髋部的异位骨化移植，成功治愈了该病例。
结论
在特殊情况下，成熟异位骨化的自体移植是治疗骨不连缺损的一种有吸引力的骨移植选择。
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