异体脱脂骨板加自体腓骨移植治疗前臂节段性骨缺损

Reconstruction of segmental forearm bone defects by using allogeneic defatted bone plate plus autogenous fibula transplantation

目的探讨尺骨或桡骨单根节段性骨缺损的治疗方法。方法自1997年1月至2003年1月共收治尺骨节段性骨缺损10例,桡骨节段性骨缺损2例。采用自体游离腓骨桥接骨缺损、钢板加对侧骨板双固定治疗。结果10例切口Ⅰ期愈合,2例Ⅱ期愈合。随访时间12～36个月,平均25个月;骨缺损愈合时间4～8个月,平均6个月20d,无骨不连患者。前臂旋转功能参照Grace评定标准,优3例,良5例,一般2例,差2例。结论采用自体腓骨桥接尺或桡骨骨缺损,钢板、骨板双固定是一种治疗尺或桡骨节段性骨缺损较理想的方法。

Objective To explore the treatment methods for segmental ulnar or radial bone defects. Methods From January 1997 to January 2003, 10 cases of segmental ulnar defects and two segmental radial defects were treated with autogenous free fibula bridging bone defects and with internal fixation using compressed plate plus contralateral bone plate. The second surgical technique consisted of removal of the necrotic bone, filling of the bone defect with an intercalary bone graft and internal fixation with a contralateral cortical bone graft. Results Ten cases obtained bone union at I stage and two at Ⅱ stage. The follow up was 12-36 months （average 25 months）. Bone union was achieved in all cases with time for 4-8 months （ mean six months and 20 days）. Bone ununion was not found. According to Grace and Eversmann＇ s criteria, the rotation function of the forearm was excellent in three cases, good in five, fair in two and poor in two. Conclusion Autogenous fibula bridging ulnar or radial bone defects as well as steel plate and bone plate is an effective and safe method for treatment of segmental forearm bone defects.