四种不同类型带血供腓骨移植的临床应用

Clinical Application of Four Types of Vascularized Fibula Transplantation

作者分别采用膝下外血管、腓血管为蒂的游离腓骨移植和以腓动脉为蒂的腓骨顺行或逆行转位移植,治疗13例炎症、肿瘤、先天性畸型造成的尺桡骨(包括骨骺)缺损。结果:以膝下外血管为蒂的腓骨上段骨(骨骺)移植,修复桡骨远端缺损,重建桡腕关节疗效满意,1例骨骺移植,获较好的继续生长,随访3年,与对侧等长,以腓动脉为蒂的腓骨干移植,无论是游离或转位移植,用于修复长度〉6cm的长骨缺损疗效满意。

Thirteen cases of defects in ulna in ulna or radius (including epiphysis) resulted from inflammation, tumor and congenital deformity were treated with free transplantation of upper segment of fibula (epiphysis) pedicled with lateral inferior genicular vessel or fibulas vessel and direct or reverse transplantation of collateral vascularized fibula graft. Result: good results were obtained to repair the distal radius defect (and reconstruct wrist joint) with free transplantation of upper fibula segment pedicled with lateral interior genicular vessel. One case with fibula epiphysis graft pedicled in the same vessel got good bone growth. The length of radius was equal to the another size 3 years after operation. Application of vascularized fibula transplantation to repair bone defect of more than 6cm in distance is useful and get satisfactory result.