Vesseur Maud A M, Dorling Isobel M, Boonen Bert, Reisinger Kostan W, van Vugt Raoul
Department of Orthopaedic Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.
Department of (Trauma) Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.
Acta Chir Belg. 2025 Jun;125(3):148-155. doi: 10.1080/00015458.2025.2467482. Epub 2025 Feb 18.
Tibial fractures, with an annual incidence of 51.7 per 100.000 adults, often result in complications like non-union and infection, particularly in open fractures. Non-union rates after intramedullary nailing are 9.7%. Hypertrophic non-union stems from unstable fracture sites, while atrophic non-union arises from inadequate biological environments. Treatment involves rigid bone fixation for hypertrophic non-union and combining biological tissue supply with mechanical stability for atrophic non-unions. This case report outlines a complex tibial non-union post-high-impact injury, detailing the surgical technique and TRUMATCH Graft Cage-Long Bone usage. In addition, we outlined the current literature on this topic.
A male patient suffered a traumatic Gustilo II comminuted tibia and fibula fracture, Lisfranc injury and a Schatzker I tibial plateau fracture of the right leg. During follow-up the patient developed an aseptic non-union with eight-centimeter anterolateral bone defect after primary surgery. Surgical intervention was performed using the three-dimensional printed TRUMATCH Graft Cage-Long Bone. At one year follow-up, clinical and radiological consolidation of the right tibia was seen.
This case report describes a challenging case of aseptic traumatic non-union of the tibia with a critical-sized defect treated with a novel patient-specific implant in a one-stage procedure. The application of the TRUMATCH Graft Cage-Long Bone is promising and warrants further investigation in larger, more controlled studies to substantiate our findings.
胫骨骨折的年发病率为每10万名成年人中有51.7例,常导致骨不连和感染等并发症,尤其是开放性骨折。髓内钉固定后的骨不连发生率为9.7%。肥大性骨不连源于骨折部位不稳定,而萎缩性骨不连则源于生物环境不足。治疗方法包括对肥大性骨不连进行坚强的骨固定,对萎缩性骨不连则将生物组织供应与机械稳定性相结合。本病例报告概述了高能量冲击损伤后复杂的胫骨骨不连情况,详细介绍了手术技术及TRUMATCH移植笼状长骨的使用。此外,我们还概述了关于该主题的现有文献。
一名男性患者右小腿遭受创伤性Gustilo II型胫腓骨粉碎性骨折、Lisfranc损伤及Schatzker I型胫骨平台骨折。在随访过程中,患者在初次手术后出现无菌性骨不连,伴有8厘米的前外侧骨缺损。采用三维打印的TRUMATCH移植笼状长骨进行手术干预。在术后一年的随访中,右胫骨实现了临床和影像学愈合。
本病例报告描述了一例具有挑战性的胫骨无菌性创伤性骨不连病例,伴有临界大小的骨缺损,采用新型个体化植入物进行一期手术治疗。TRUMATCH移植笼状长骨的应用前景广阔,需要在更大规模、更具对照性的研究中进一步探究以证实我们的发现。