Kasashima T, Minami A, Kutsumi K
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Microsurgery. 1998;18(5):337-43. doi: 10.1002/(sici)1098-2752(1998)18:5<337::aid-micr8>3.0.co;2-h.
Subsequent fractures following the bone union were analyzed in 62 cases of vascularized fibular graft reconstruction. Fifteen cases (24%) of fractures, including four cases of two fractures, were observed. All fractures but one occurred within a year after obtaining bone union. Eighteen fractures occurred in the lower extremity. In the patients with tibial reconstructions, a significantly higher incidence of fractures was demonstrated in cases where there was a large bone defect and an inaccurate alignment of the graft. Proper graft alignment is an important factor in preventing stress fractures. Vascularized fibular grafts should be protected against excessive mechanical stresses during the first year following bony graft union.
在62例带血管腓骨移植重建病例中，分析了骨愈合后的后续骨折情况。观察到15例（24%）骨折，其中包括4例发生两次骨折的病例。除1例外，所有骨折均发生在骨愈合后的一年内。18例骨折发生在下肢。在胫骨重建患者中，骨缺损大且移植骨对线不准确的病例骨折发生率显著更高。正确的移植骨对线是预防应力性骨折的重要因素。带血管腓骨移植在骨移植愈合后的第一年应避免承受过大的机械应力。
