Youssef Mustafa, AbdalMoneim Hafez Mohamed, Elsayed Semaya Ahmed, El-Sayed Amr
El Hadra University Hospital, Department of Orthopedics Surgery and Traumatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Orthopedics Surgery and Traumatology, Faculty of Medicine, Assiut University, Assiut, Egypt.
J Hand Microsurg. 2024 Dec 8;17(2):100198. doi: 10.1016/j.jham.2024.100198. eCollection 2025 Mar.
Vascularized bone grafts (VBGs) are currently the main surgical option for the restoration of humeral bone defects particularly when defects are larger than 6 cm. Because it offers a strong, rapid blood supply, VBGs easily integrate into the recipient sites and undergo active resorption and remodeling into healthy bone through primary bone healing. Additionally, they support the recipient site's immune system in preventing and reducing infection. was to assess the outcomes of utilizing vascularized bone grafts to reconstruct large humeral bony defects (greater than 6 cm).
This study comprised twenty patients with major humeral bony defects treated by vascularized bone grafts. Under general anesthesia, the procedure was carried out with the patient in the supine position for free fibula harvesting or in the lateral or prone position for pedicled scapular graft harvesting.
The union rate was 90 % and the mean healing time was 7.78 ± 3.04 months. Complications were present in 40 % of cases, with non-union being the most common, followed by infection and wound dehiscence.
The study suggests that the reconstruction of large bony defects of humerus using vascularized bone grafts is effective, with a predictable healing time and a manageable complication rate.
血管化骨移植(VBGs)目前是修复肱骨骨缺损的主要手术选择,尤其是当缺损大于6厘米时。由于其提供强大、快速的血液供应,血管化骨移植很容易融入受体部位,并通过一期骨愈合积极吸收和重塑为健康骨骼。此外,它们还支持受体部位的免疫系统预防和减少感染。本研究旨在评估利用血管化骨移植重建大型肱骨骨缺损(大于6厘米)的效果。
本研究纳入了20例接受血管化骨移植治疗的肱骨大骨缺损患者。在全身麻醉下,手术在患者仰卧位进行游离腓骨采集,或在侧卧位或俯卧位进行带蒂肩胛部骨移植采集。
愈合率为90%,平均愈合时间为7.78±3.04个月。40%的病例出现并发症,其中不愈合最为常见,其次是感染和伤口裂开。
该研究表明,使用血管化骨移植重建肱骨大骨缺损是有效的,愈合时间可预测,并发症发生率可控。