Kirschner M H, Wagner F D, Nerlich A, Land W, Bühren V, Hofmann G O
Department of Surgery, Ludwig-Maximilians University Munich, Germany.
Transpl Int. 1998;11(3):195-203. doi: 10.1007/s001470050127.
Trauma surgery lack, substitute, for the reconstruction of large defects of the long bones. Encouraged by the promising results of bone allotransplantation in animal models, we successfully performed vascularized bone transplantation in humans. Vascularized femoral diaphyses were allogenically transplanted into three patients suffering from chondrosarcoma or post-traumatic osteomyelitis with postoperative immunosuppression. The bone segments were harvested from multi-organ donors and perfused with UW solution. After back-table preparation, the grafts were transplanted into the defect zone. Interlocking devices were used in these operations. Vascular anastomoses were performed in end-to-side technique. The early clinical course of the patients was not free of anatomical, technical, or immunological complications. However, all patients are currently free of malignancy and infection. They are also free of pain and full weight bearing. We conclude that allogenic grafting of vascularized bone segments has the potential to become an alternative for the replacement of large bone defects.
创伤外科缺乏用于重建长骨大段骨缺损的替代方法。受动物模型中同种异体骨移植的良好结果鼓舞，我们成功地在人体中进行了带血管骨移植。将带血管的股骨干同种异体移植到3例患有软骨肉瘤或创伤后骨髓炎的患者中，并在术后进行免疫抑制。骨段取自多器官供体，并用UW溶液灌注。在后台准备后，将移植物移植到缺损区域。这些手术中使用了交锁装置。血管吻合采用端侧技术。患者的早期临床过程并非没有解剖学、技术或免疫并发症。然而，所有患者目前均无恶性肿瘤和感染。他们也没有疼痛，可以完全负重。我们得出结论，带血管骨段的同种异体移植有可能成为替代大段骨缺损的一种选择。
