Thiel Johannes Tobias, Bamberg Maximilian, Daigeler Adrien, Fontana Johann, Hoffmann Sebastian, Illg Claudius, Kolbenschlag Jonas, Steiner Dominik, Lauer Henrik
Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Tübingen, University of Tübingen, 72076 Tübingen, Germany.
Department of Anesthesiology and Intensive Care Medicine, BG Trauma Center Tübingen, Schnarrenbergstr. 95, 72076 Tübingen, Germany.
Life (Basel). 2024 Aug 31;14(9):1099. doi: 10.3390/life14091099.
Large bone defects of the distal radius and/or carpus following tumor resection, trauma, or infection are extremely rare. There are few case reports and series in the literature on the reconstruction approaches required in such cases. Therefore, large studies cannot be used to guide the therapeutic decisions of reconstructive plastic and hand surgeons. The objective of this study is to propose a treatment algorithm to predict the functional outcome and quality of life for the different techniques of free vascularized bone reconstruction in the interval between the distal radius, the carpus, and/or the proximal metacarpal. The algorithm was developed based on our own case studies and the few treatment approaches described in the literature. It can be applied to rare cases of massive bone defects in the wrist. The flowchart enables surgeons to develop an individualized reconstruction concept for various intervals of bone defects in the area of the distal radius and proximal metacarpal bones. Ultimately, the treatment algorithm aims to maximize future quality of life (QoL) and function of the distal upper extremity in rare cases of massive wrist-bone defects.
肿瘤切除、创伤或感染后桡骨远端和/或腕骨出现大的骨缺损极为罕见。关于此类病例所需重建方法的文献中病例报告和系列研究很少。因此，无法通过大型研究来指导重建整形和手外科医生的治疗决策。本研究的目的是提出一种治疗算法，以预测桡骨远端、腕骨和/或近端掌骨之间不同游离血管化骨重建技术的功能结果和生活质量。该算法是基于我们自己的病例研究以及文献中描述的少数治疗方法开发的。它可应用于腕部巨大骨缺损的罕见病例。该流程图使外科医生能够针对桡骨远端和近端掌骨区域不同间隔的骨缺损制定个性化的重建方案。最终，该治疗算法旨在使罕见的腕部巨大骨缺损病例中上肢远端的未来生活质量（QoL）和功能最大化。
