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创伤后大段骨缺损——骨搬运是否可避免成功软组织覆盖的需求——病例报告

Post-Traumatic Large Segmental Bone Loss - Does Bone Transport Obviate the Need for Successful Soft-Tissue Cover - A Case Report.

作者信息

Pentela Hari Krishna, Harshavardhan J K Giriraj, Suriyakumar Sundar

机构信息

Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

出版信息

J Orthop Case Rep. 2023 May;13(5):9-13. doi: 10.13107/jocr.2023.v13.i05.3626.

DOI:10.13107/jocr.2023.v13.i05.3626
PMID:37255649
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10226645/
Abstract

INTRODUCTION

Management of open tibial fractures with large bone segment and soft-tissue loss can be challenging. To restore the functionality of the limb, the continuity of the soft-tissue envelope and bone needs to be achieved.

CASE REPORT

A 29-year-old gentleman sustained right leg crush injury and open Gustilo Anderson Grade IIIB right tibia shaft fracture with 17.2 cm tibial shaft bone segment loss and large soft-tissue defect. An initial free flap failed. In spite of this, the functionality of the limb was restored by bone transport using Ilizarov method.

CONCLUSION

The case report details the surgical technique and obstacles encountered and illustrate that bone transport using Ilizarov technique not only regenerates bone but can facilitate healing of soft tissues.

摘要

引言

处理伴有大骨段缺损和软组织缺失的开放性胫骨骨折具有挑战性。为恢复肢体功能，需要实现软组织包膜和骨骼的连续性。

病例报告

一名29岁男性遭受右腿挤压伤，开放性Gustilo Anderson IIIB级右胫骨干骨折，伴有17.2厘米胫骨干骨段缺损和大面积软组织缺损。首次游离皮瓣手术失败。尽管如此，通过使用伊里扎洛夫方法进行骨搬运，肢体功能得以恢复。

结论

该病例报告详细介绍了手术技术及遇到的障碍，并表明使用伊里扎洛夫技术进行骨搬运不仅能再生骨骼，还可促进软组织愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/60423f041582/JOCR-13-9-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/a73b94ec4aa6/JOCR-13-9-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/c2bc514a3eac/JOCR-13-9-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/60423f041582/JOCR-13-9-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/a73b94ec4aa6/JOCR-13-9-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/c2bc514a3eac/JOCR-13-9-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d7a/10226645/60423f041582/JOCR-13-9-g003.jpg

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Strategies Trauma Limb Reconstr. 2020 May-Aug;15(2):106-116. doi: 10.5005/jp-journals-10080-1466.
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Management of critical-sized bone defects in the treatment of fracture-related infection: a systematic review and pooled analysis.
治疗骨折相关感染的临界尺寸骨缺损的管理：系统评价和荟萃分析。
Arch Orthop Trauma Surg. 2021 Jul;141(7):1215-1230. doi: 10.1007/s00402-020-03525-0. Epub 2020 Aug 29.
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