同侧带血管蒂腓骨轴向旋转内移术治疗胫骨大段骨缺损

Management of tibial defect with ipsilateral rotational pedicled fibular flap

目的探讨同侧带血管蒂腓骨180°轴向旋转内移术治疗胫骨大段骨缺损的治疗方法和疗效.方法根据胫骨缺损的长度,切取同侧带血管蒂腓骨并180°轴向旋转内移至胫骨缺损区,将腓骨两端分别插入胫骨髓腔内,远端用螺钉将胫腓骨固定,同时将远端残留腓骨与胫骨融合,预防术后踝关节不稳定.结果手术治疗16例,经4个月～19年随访,骨愈合时间接近正常,踝关节功能无明显障碍.结论同侧带血管蒂腓骨180°轴向旋转内移术,术式简捷,效果良好,是治疗胫骨大段骨缺损的一种值得推荐的理想方法.

Objective To review the treatment of massive tibial defects with the ipsilateral vascular pedicled fibular flap.Methods Ipsilateral fibular vascular pedicle flap was dissected out and inserted into the tibial defect. Both the ends of fibula graft were inserted into the tibial medullary cavity. The distal fibula was fixed to tibia with a screw.Results Sixteen patients were operated. The patient observation was between 4 months to19 years. The bony union was good and there was no dysfunction in ankle joint.Conclusions Vascular pedicle fibular flap can be applied with good results in treatment of large tibial defect.