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[通过桡骨尺骨化重建前臂骨质缺损(单骨前臂)。附6例报告]

[Reconstruction of the loss of bone substance of the forearm by cubitalization of the radius (one bone forearm). Apropos of 6 cases].

作者信息

Bessy H, Leemrijse T, Cadot B, Touam C, Oberlin C

机构信息

Service de chirurgie Orthopédique et Reconstructrice de l'Hôpital Bichat, Paris.

出版信息

Ann Chir Main Memb Super. 1996;15(4):199-211. doi: 10.1016/s0753-9053(96)80027-5.

Abstract

Extensive forearm bone loss, whatever its etiology, presents a difficult reconstruction problem. This is mainly the case in the presence of lesions of the interosseous membrane associated with the radio-ulnar joint. When preservation of forearm rotation is not possible, cubitalization of the radius and reconstruction of the forearm by creation of a "one bone forearm" seems to be an excellent salvage technique both functionally and cosmetically. Our experience concerns six clinical cases; two of these cases are original and give the authors the opportunity to describe a new reconstructive technique of the distal humerus and elbow by vascularized transfer of the radius onto the radial artery (with a cutaneo-osseous transfer in one case). The etiology of the bone defect included severe trauma in three cases, and a Volkman's syndrome complicated by osteomyelitis in one case. Two cases represent an original technique of reconstruction of the distal humerus by a vascularised transfer of the radius onto the radial artery. Forearm reconstruction is performed by cubitalization of the radius. The etiology was traumatic in one case and neoplastic in another, and a cutaneo-osseous transfer was performed in the latter case. In this difficult problem of bone reconstruction, a favorable functional and cosmetic result was obtained in our series.

摘要

无论病因如何,广泛的前臂骨质流失都会带来棘手的重建问题。尤其是在存在与桡尺关节相关的骨间膜损伤的情况下。当无法保留前臂旋转功能时,将桡骨尺骨化并通过创建“单骨前臂”来重建前臂,在功能和美观方面似乎都是一种出色的挽救技术。我们的经验涉及6例临床病例;其中2例为原创病例,使作者有机会描述一种通过带血管蒂的桡骨转移至桡动脉来重建肱骨远端和肘关节的新方法(其中1例为带皮骨转移)。骨缺损的病因包括3例严重创伤,1例合并骨髓炎的Volkmann挛缩症。2例展示了通过带血管蒂的桡骨转移至桡动脉来重建肱骨远端的原创技术。前臂重建通过桡骨尺骨化进行。病因1例为创伤性,另1例为肿瘤性,后者进行了带皮骨转移。在这个棘手的骨重建问题上,我们的系列病例取得了良好的功能和美观效果。

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