Zeckey Christian, Ehrl Denis, Kammerlander Christian, Böcker Wolfgang, Neuerburg Carl
Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.
Klinik für Unfallchirurgie und Orthopädie, RoMed Klinikum Rosenheim, Pettenkoferstr. 10, 83022, Rosenheim, Deutschland.
Unfallchirurg. 2020 Oct;123(10):816-821. doi: 10.1007/s00113-020-00827-1.
Bone loss of the distal tibia represents a major challenge for the treating surgeons and the reconstruction technique. This is particularly true for septic bone loss. Several techniques are available, ranging from callus distraction of Ilizarov frames and monorail techniques as well as transport with plates and nails; however, implants for internal segmental transport for bone defects have so far not been available. This case report describes worldwide the first reconstruction of a distal tibial defect by reconstruction of the major arterial flow path with flap coverage and all inside segmental transport using a motorized segmental transport nail without additional osteosynthesis or add-on module.
胫骨远端的骨质缺损对治疗外科医生和重建技术而言是一项重大挑战。对于感染性骨质缺损来说尤其如此。有多种技术可供选择，从伊利扎罗夫框架的骨痂牵张术、单轨技术以及钢板和髓内钉转运技术；然而，用于骨缺损节段性内部转运的植入物目前尚未问世。本病例报告在全球范围内首次描述了通过皮瓣覆盖重建主要动脉血流路径，并使用电动节段性转运髓内钉进行全内部节段性转运，而无需额外的骨固定或附加模块来重建胫骨远端缺损。
