Mahaisavariya B, Mahakkanukrah C, Rojviroj S, Jiraratanaphochai K
Department of Orthopaedics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 1994 Mar;77(3):113-9.
Five children with congenital pseudarthrosis of the tibia were treated by resection of the lesion and reconstruction of the extremity with a free vascularized fibular graft (FVFG). Two of five cases had had multiple surgical procedures before FVFG. These two cases were complicated with the non-union of the proximal grafthost junction. Of these, one case achieved bone union after further resection of the non-union and adding allogenic bone graft and another case denied further operation and was lost to follow-up 6 months postoperatively. Three cases, two of which underwent FVFG as a primary treatment and another one after failure from the Sofield procedure respectively, were initially treated successfully and solid union of the grafthost junctions was within four months postoperatively. Problems including: anterior bowing, refracture, valgus deformity of the ankle and leg length discrepancy occurred in all four followed cases.
5例先天性胫骨假关节患儿接受了病损切除及游离带血管腓骨移植（FVFG）重建肢体治疗。5例中有2例在接受FVFG之前已接受过多次手术。这2例近端移植-宿主连接部位出现骨不连。其中1例在进一步切除骨不连部位并加用同种异体骨移植后实现了骨愈合，另1例拒绝进一步手术，术后6个月失访。3例最初治疗成功，移植-宿主连接部位在术后4个月内实现牢固愈合，其中2例分别将FVFG作为初次治疗，另1例在索菲尔德手术失败后接受FVFG治疗。随访的4例均出现了包括前弓、再骨折、踝关节外翻畸形和肢体长度差异等问题。
