Wright Edmund Hugh, Bourke Grainne, Giannoudis Peter V
Departments of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds, UK.
Leeds Institute for Medical Research, University of Leeds, Leeds, UK.
Trauma Case Rep. 2022 Feb 7;39:100619. doi: 10.1016/j.tcr.2022.100619. eCollection 2022 Jun.
We present a case of spontaneous osteomyelitis of the left ulna in a 25-year-old man. There was no history of trauma or haematogenous source identified. Bone biopsy found on culture, sensitive to flucloxacillin, but antibiotic treatment was unsuccessful. He underwent excision of the osteomyelitic ulna and a vascularised free fibula graft (VFF graft) reconstruction of the bony defect (18 cm in length), using the ulnar artery at the wrist as recipient vessel. Six months later he was found to have radiological evidence of bony resorption at the proximal fibula-ulnar junction. He underwent resection of a 5 cm segment of the fibula flap and insertion of an antibiotic-impregnated cement spacer in preparation for the placement of bone graft as per Masquelet technique. Following bone graft placement, he united 4 months later. This case demonstrates that the Masquelet technique can be used successfully as an adjunct to VFF graft when reconstructing very long bony defects.
我们报告一例25岁男性自发性左尺骨骨髓炎病例。患者无创伤史或血源性感染源。骨活检培养结果显示对氟氯西林敏感，但抗生素治疗未成功。他接受了尺骨骨髓炎病灶切除及血管化游离腓骨移植（VFF移植）修复骨缺损（长度为18厘米），采用腕部尺动脉作为受区血管。6个月后，发现其近端腓尺关节处有骨质吸收的影像学证据。他接受了腓骨瓣5厘米节段的切除，并插入抗生素骨水泥间隔物，为按照Masquelet技术植入骨移植做准备。植入骨移植后，4个月后实现骨愈合。该病例表明，在重建非常长的骨缺损时，Masquelet技术可成功作为VFF移植的辅助方法。
