Fowles J V, Lehoux J, Zlitni M, Kassab M T, Nolan B
J Bone Joint Surg Br. 1979 Feb;61(1):77-81. doi: 10.1302/0301-620X.61B1.422639.
The management of twenty-one children with a defect of the tibial shaft due to acute haematogenous osteomyelitis is described. Half the defects were due to removal of the sequestrum before the involucrum had formed. Only four patients, all under ten years of age, had spontaneous regeneration of the shaft. Eleven children had a posterior tibiofibular graft and six had a transfer of the ipsilateral fibular diaphysis. The results of operation were superior to those of spontaneous regeneration. All the grafts united and the children returned home to lead normal lives. Shortening was only a problem when growth plates or adjacent joints had been damaged. We now leave the sequestrum for up to one year after the onset of infection. If the involucrum fails to form we reconstruct the tibia as soon as possible after sequestrectomy.
本文描述了21例因急性血源性骨髓炎导致胫骨干缺损患儿的治疗情况。半数缺损是由于在骨痂形成前摘除了死骨。只有4例年龄均在10岁以下的患儿胫骨干实现了自发再生。11例患儿接受了胫腓骨后侧植骨，6例患儿接受了同侧腓骨干中段移位术。手术效果优于自发再生。所有移植骨均愈合，患儿均回家过上了正常生活。只有当生长板或相邻关节受损时，才会出现肢体短缩问题。我们现在在感染发作后将死骨保留长达一年。如果骨痂未能形成，我们在摘除死骨后尽快重建胫骨。
