Bumbic S
Chir Pediatr. 1986;27(6):356-8.
Dragan Dj./Re. No. 2755/76, 5,5-year-old boy, referred to this hospital with signs of bipolar osteomyelitis, destruction and fistulisation of the left tibia and talocrural arthritis. Staphylococcus albus and streptococcus haemoliticus were isolated from the fistula. Osteomyelitis was treated with an adequate therapy including long usage of Lincocin. In Feb. and Oct. of 1977 a sequestrotomy of the mid portion of the tibia and transmedular fixation using Ratschmann's nail were performed. The process resulted in pseudarthrosis of the mid portion of the tibia with loss of bone substance in the length of 2.5 cm and talocrural arthrosis and deformed foot. The boy walking support. In July 1980, in the stage of "ripe" pseudarthrosis a complete resection of pseudoarthrosis with sclerotic portions of tibia to healthy bone was performed. The mid part of the right tibia was resected subperiostally and was grafted centromedularlly into the upper and lower medular channel of the left tibia. Two Kirschner's needles were implanted centromedularlly so as to strengthen the bone osteosynthesis. Complete union of the grafted fibula with treppassage of the medular channel occurred with its tibilisation and growth in length and width. In July 1982, the concave foot was corrected using Bertrand's method. The present difference in the length between the two legs is 4.5 cm which is corrected by the use of padded shoes. Lengthening of the leg is planned to be performed before he reaches the age of 14.
德拉甘·德热（病历号2755/76），一名5岁半男孩，因双相性骨髓炎、左胫骨破坏与瘘管形成以及距小腿关节炎症状被转诊至本院。从瘘管中分离出白色葡萄球菌和溶血性链球菌。骨髓炎采用了包括长期使用林可霉素在内的适当治疗方法。1977年2月和10月，对胫骨中部进行了死骨切除术，并使用拉奇曼氏钉进行了髓内固定。术后导致胫骨中部假关节形成，骨质缺损长度达2.5厘米，伴有距小腿关节病和足部畸形。患儿需借助辅助器械行走。1980年7月，在假关节“成熟”阶段，对假关节连同胫骨硬化部分进行了完整切除，直至健康骨质。右胫骨中部在骨膜下被切除，并经髓内移植至左胫骨的上下髓腔。两根克氏针经髓内植入以加强骨的骨合成。移植的腓骨完全愈合，髓腔贯通，其向胫骨转化并在长度和宽度上生长。1982年7月，采用伯特兰方法矫正了内翻足。目前双腿长度差为4.5厘米，通过穿增高鞋垫进行矫正。计划在他14岁之前进行腿部延长手术。
