Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.
Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
BMJ Case Rep. 2023 Nov 14;16(11):e254863. doi: 10.1136/bcr-2023-254863.
A man in his 30s was involved in a road traffic accident (RTA) and sustained a grade-IIIA distal femur fracture with acute loss of distal two-third of the femur. Initially, damage control surgery was done by an external fixator application. Later, staged limb reconstruction surgery was undertaken as a definitive procedure that involved bifocal distraction osteogenesis involving the proximal tibia and femur along with docking of the corticotomised femoral fragment onto the tibial plateau to achieve knee arthrodesis. The tibial and femoral regenerate together measured 25.8 cm at the end of distraction phase leaving behind a limb length discrepancy of 5 cm. Acute traumatic large bone loss is a rare presentation and is beset with unique management challenges. Limb reconstruction surgery (LRS) with LRS system provides flexibility to tackle individual case-based scenarios and helps achieve limb length, maintain alignment and restore function.
一名 30 多岁的男子遭遇道路交通意外（RTA），导致股骨远端 IIIA 级骨折，股骨远端三分之二急性丧失。最初，通过外固定器应用进行了损伤控制手术。后来，作为确定性手术进行了分期肢体重建手术，包括涉及胫骨和股骨的双焦点撑开成骨术，以及将皮质切开的股骨碎片对接至胫骨平台以实现膝关节融合。在牵引阶段结束时，胫骨和股骨再生共 25.8 厘米，留下 5 厘米的肢体长度差异。急性创伤性大骨丢失是一种罕见的表现，存在独特的管理挑战。使用肢体重建系统（LRS）进行肢体重建手术（LRS）提供了灵活性，可以解决基于个别病例的情况，并有助于实现肢体长度、保持对线和恢复功能。
