Department of Surgery, Cedarcrest Hospitals, Abuja, Nigeria.
Niger J Clin Pract. 2021 Jul;24(7):1096-1099. doi: 10.4103/njcp.njcp_395_20.
Chronic osteomyelitis of the tibia is a common sequela of acute osteomyelitis which may present with a bone defect following sequestrectomy. Treatment of the gap nonunion can be done with the ipsilateral fibula as a strut graft when harvested subperiosteally and this leads to good outcome. A 7-year-old girl presented to our facility with a 25 cm defect of her right tibia following sequestrectomy for chronic osteomyelitis in another facility. X-rays revealed a healthy tibia superiorly and inferiorly with an intact fibula. She subsequently had an ipsilateral subperiosteal nonvascularized fibula harvest which was used to fill the tibia defect as a strut graft. The synostosis healed perfectly and the fibula reossified, time to union was 17 weeks, and the patient commenced full weight-bearing thereafter. Management of bone gap following sequestrectomy for chronic osteomyelitis remains a challenge to the orthopedic surgeon. The subperiosteal fibular harvest and use as a strut graft is a viable option with good outcomes. Our experience with this case may serve as a way out of this usual challenge.
胫骨慢性骨髓炎是急性骨髓炎的常见后遗症，在病灶清除术后可能会出现骨缺损。对于骨间隙不愈合的治疗，可以采用同侧腓骨作为支撑植骨，腓骨通过骨膜下采集，可获得良好的效果。一名 7 岁女孩因在另一家医院接受慢性骨髓炎病灶清除术后出现右胫骨 25 厘米缺损，来到我院就诊。X 光片显示胫骨上下部骨质健康，腓骨完整。随后，她接受了同侧腓骨骨膜下非血管化采集，用作支撑植骨填充胫骨缺损。骨桥愈合良好，腓骨重新骨化，愈合时间为 17 周，此后患者开始完全负重。对于慢性骨髓炎病灶清除术后骨间隙的处理仍然是骨科医生面临的挑战。腓骨骨膜下采集并用作支撑植骨是一种可行的选择，可获得良好的效果。我们的经验可能为解决这一常见挑战提供了一种方法。
