Moore J R, Weiland A J, Daniel R K
Clin Orthop Relat Res. 1983 May(175):37-44.
A five-year experience with ten cases of primary resection of aggressive bone lesions treated by immediate reconstruction with autologous fibula demonstrates the advantages of vascularized, compared with free bone, graft. The procedure was performed for locally aggressive bone tumors in seven cases, and for Type III congenital pseudarthroses of the tibia in three cases. In large intercalary bone grafts, the vascularized fibula actively participates in the healing process, rather than serving merely as a framework for inductive creeping substitution, as is the case in conventional bone grafts. With the exception of one case, the grafts united and progressively hypertrophied, and there was no tumor recurrence. For defects less than 6 cm in diameter, conventional bone grafts usually prove successful. However, for defects greater than 6 cm or in a poorly vascularized bed, the vascularized fibular graft can prevent such complications as fatigue fracture, failure of incorporation, and nonunion that are frequently seen with nonvascularized cortical and cancellous bone grafts.
一项针对10例侵袭性骨病变进行一期切除并立即采用自体腓骨重建的五年经验表明，与游离骨移植相比，带血管蒂移植具有优势。该手术用于7例局部侵袭性骨肿瘤，3例胫骨III型先天性假关节。在大型节段性骨移植中，带血管蒂的腓骨积极参与愈合过程，而不仅仅像传统骨移植那样仅作为诱导性潜行替代的框架。除1例病例外，移植骨均愈合并逐渐肥大，且无肿瘤复发。对于直径小于6厘米的缺损，传统骨移植通常证明是成功的。然而，对于直径大于6厘米或血供不良部位的缺损，带血管蒂的腓骨移植可预防诸如疲劳骨折、植入失败和骨不连等非带血管蒂皮质骨和松质骨移植常见的并发症。
