Rasmussen M R, Bishop A T, Wood M B
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Bone Joint Surg Am. 1995 May;77(5):751-9. doi: 10.2106/00004623-199505000-00011.
We retrospectively reviewed the records of thirteen patients who had been managed with an arthrodesis of the knee with use of a vascularized graft from the ipsilateral fibula and fixation with an intramedullary rod. The indications for the operation included a large skeletal defect secondary to the resection of a tumor about the knee in eight patients, an infection at the site of an arthroplasty in four (with failure of a previous conventional arthrodesis in three of the four), and severe rheumatoid gonarthrosis as well as a persistent non-union of the distal part of the femur in one. The average age of the patients at the time of the operation was forty-three years (range, twenty-six to seventy-six years). Most of the patients had had multiple previous procedures (thirty-three operations had been performed in ten patients). Twelve of the thirteen patients had a solid fusion and a successful result after an average duration of follow-up of fifty-one months (range, eight to ninety-three months). The remaining patient, who had had four previous arthroplasties, had a recurrence of an infection seven months after the operation and was managed with an amputation. Six complications--including two superficial wound infections, one deep wound infection, one deep venous thrombosis, one transient peroneal-nerve palsy, and one delayed union--occurred in three patients.
我们回顾性分析了13例采用同侧腓骨带血管蒂骨移植并髓内棒固定进行膝关节融合术患者的病历资料。手术适应证包括：8例因膝关节周围肿瘤切除导致大的骨缺损；4例人工关节置换部位感染（其中3例先前常规关节融合术失败）；1例严重类风湿性膝关节炎以及1例股骨远端持续不愈合。患者手术时的平均年龄为43岁（范围26至76岁）。大多数患者先前接受过多次手术（10例患者共接受33次手术）。13例患者中有12例获得牢固融合，平均随访51个月（范围8至93个月）后结果成功。其余1例患者先前接受过4次人工关节置换术，术后7个月感染复发，最终接受截肢治疗。3例患者出现了6种并发症，包括2例表浅伤口感染、1例深部伤口感染、1例深静脉血栓形成、1例短暂性腓总神经麻痹和1例延迟愈合。
