Hôpital Saint Antoine, Paris, France.
Hôpital Saint Antoine, Paris, France.
Orthop Traumatol Surg Res. 2021 Dec;107(8):103074. doi: 10.1016/j.otsr.2021.103074. Epub 2021 Sep 24.
The unique anatomical characteristics of the forearm bones makes their reconstruction challenging. The aim of this study was to report the surgical methods and results of the induced membrane technique applied to traumatic forearm bone defects.
We evaluated retrospectively a case series of 13 patients operated between 2010 and 2017. The first surgical step consisted of debridement of the fracture site and implantation of a cement spacer with appropriate fixation. The anatomy of the forearm skeleton had to be restored. The second step, done 6 weeks later, consisted of removing the cement spacer and applying cancellous bone autograft harvested from the iliac crest. The outcome measures were radiological bone union, need for surgical revision, and postoperative wrist range of motion.
All 13 patients were men, with a mean age of 39 years (18-67). The average follow-up was 2.5 years. Eleven patients were suffering from a nonunion and two from a post-traumatic bone defect. Six patients had an identified preoperative infection. Three patients had previously undergone an unsuccessful treatment for their nonunion with bone addition. The maximum length of bone reconstruction was 12 cm. Union was achieved in 12 of 13 patients in a mean of 5 months (3-8). The other patient died during the postoperative course. Two patients needed revision surgery: ulnar shortening osteotomy (1 case) and additional tendon reconstruction (1 case). The mean pronosupination range was 123° on average (55-180°). The mean flexion-extension range was 106° (90-130°).
The induced membrane technique is a reliable reconstruction technique that is well suited to reconstruction of the forearm skeleton.
IV, retrospective study.
前臂骨的独特解剖特征使其重建具有挑战性。本研究旨在报告应用诱导膜技术治疗外伤性前臂骨缺损的手术方法和结果。
我们回顾性评估了 2010 年至 2017 年间接受手术的 13 例患者的病例系列。第一步手术包括清创骨折部位，并植入适当固定的水泥间隔器。必须恢复前臂骨骼的解剖结构。第二步在 6 周后进行，包括取出水泥间隔器，并应用取自髂嵴的松质骨自体移植物。评估指标包括影像学骨愈合、手术修正的需要以及术后腕关节活动范围。
13 例患者均为男性，平均年龄 39 岁（18-67 岁）。平均随访时间为 2.5 年。11 例患者存在骨不连，2 例存在创伤后骨缺损。6 例患者术前存在感染。3 例患者曾因骨不连接受过骨添加治疗但未成功。骨重建的最大长度为 12cm。13 例患者中的 12 例平均在 5 个月（3-8 个月）内实现了愈合。另一名患者在术后过程中死亡。2 例患者需要进行修正手术：尺骨缩短截骨术（1 例）和额外的肌腱重建（1 例）。平均旋前旋后范围为 123°（55-180°）。平均屈伸范围为 106°（90-130°）。
诱导膜技术是一种可靠的重建技术，非常适合前臂骨骼的重建。
IV，回顾性研究。
