Youdas J W, Wood M B, Cahalan T D, Chao E Y
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905.
J Orthop Res. 1988;6(5):621-9. doi: 10.1002/jor.1100060502.
Eleven patients with free vascularized fibula graft transplants to the upper extremity were studied for donor-side morbidity effects. Based on their surgical follow-up times, the patients were divided into either group 1 (5 +/- 2 months) or group 2 (21 +/- 8 months) to examine the effects of surgical trauma more closely. Gait evaluation was performed using two walkways containing different ground conditions. Knee and ankle-foot motion was measured using a three-dimensional electrogoniometer. Basic temporodistance factors and ground reactions were obtained from foot switches, instrumented floor mats, and a force plate. A modified Cybex II isokinetic dynamometer was used to quantitate ankle-foot strengths. Moderate knee and ankle-foot motion changes were seen while walking on the level, sideslope, and ramp in patients evaluated less than 10 months after their surgical procedure. Minimal joint motion effects were discovered in patients with follow-up times longer than 10 months. Muscle strengths were significantly impaired in both groups, especially foot inversion and eversion. An inverse relationship existed between the length of resected fibula and ankle evertor muscle strength. Donor side morbidity does not appear to be caused by surgical soft-tissue trauma exclusively. These patients need to be studied for several more years to determine the long-term functional effects of free vascularized fibular graft transfer.
对11例接受游离血管化腓骨移植至上肢的患者进行了供体侧并发症影响的研究。根据手术随访时间，将患者分为第1组（5±2个月）或第2组（21±8个月），以更密切地检查手术创伤的影响。使用两条地面条件不同的通道进行步态评估。使用三维电子测角仪测量膝关节和踝足运动。基本的颞距因素和地面反应通过足部开关、仪器化的地板垫和测力板获得。使用改良的Cybex II等速测力计对踝足力量进行定量。在手术后不到10个月接受评估的患者中，在平路、侧坡和斜坡上行走时可见膝关节和踝足运动有中度变化。随访时间超过10个月的患者发现关节运动影响最小。两组患者的肌肉力量均明显受损，尤其是足内翻和外翻。切除腓骨的长度与踝外翻肌力量之间存在反比关系。供体侧并发症似乎并非仅由手术软组织创伤引起。这些患者需要再研究数年，以确定游离血管化腓骨移植的长期功能影响。
