带血管蒂游离腓骨移植治疗大段骨缺损应用体会

Clinical application and experience in repairing long bone defect with free vascular fibular transplantation

目的探讨带血管蒂游离腓骨移植治疗大段骨缺损的临床应用与体会。方法对我院2002～2006年治疗的9例大段骨缺损患者诊疗过程进行回顾性分析和总结。其中胫骨骨缺损4例,前臂骨缺损2例,下颌骨骨囊肿3例,缺损最长14cm,最短6cm。结果9例患者经游离腓骨移植治疗骨缺损全部成活,术后功能良好。2例出现腓骨再骨折(胫骨骨缺损),经再手术等治疗目前可完全负重行走。有1例术后出现感染(再造下颌骨),腓骨块局部有移位,但不影响功能。结论尽管带血管蒂游离腓骨移植的手术创伤大,技术难度高,且可能引起一些术后并发症如再骨折、感染等,但目前腓骨仍然是治疗大段骨缺损的供体之一。带血管蒂游离腓骨移植治疗大段骨缺损是目前有效的方法,但应慎重选择手术适应证。

Objective Study clinical application and experience in repairing long bone defect with free vascular fibular transplantation. Methods A clinical analysis and retrospective study was carried out in 9 cases of 2002-2006. The patients of long bone defect included 4 cases of tibial, 2 cases of forearm ,3 cases of mandibles bone cyst. The longest defect was 14 cm, the shortest 6 cm. Results All the cases survived by repairing long bone defect with free vascular fibular transplantation. Two cases had refracture of fibula （ tibia- 1）, one case had infection （mandible bone cyst）, but function was good. Conclusions To repair long bone defect with free vascular fibular transplantation is difficult because of refracture or infectionetc. But fibula is good as one of donors. It is an effective method to repair long bone defect with free vascular fibular transplantation, but indication should be selected cautiously.