采用带血管腓骨移植一期修复慢性骨髓炎大段骨缺损

The repairation of long bone defect after getting rid of free bone in chronic osteomyelitis patients with vascularized fibula graft

目的探索慢性骨髓炎大段骨早期摘除后骨缺损的一期修复效果。方法胫骨慢性骨髓炎并大段骨清除后，作吻合血管腓骨移植一期予以重建１８例；作炎性骨段切除，采用带血管蒂腓骨移位一期予以修复２例。结果胫骨慢性骨髓炎在摘除大段死骨后应用吻合血管腓骨移植或带血管蒂腓骨移位重建。术后３～６个月见重建骨完全骨性愈合，邻近关节诸骨受累的炎症得到完全控制；修复肢体的功能与外形恢复令人满意。结论对慢性骨髓炎所形成大段整块死骨在作病灶清除、大段死骨摘除同时，应用吻合血管或带血管腓骨一期予以重建，可改善受区血液循环，抑制炎症漫延，缩短了住院日与住院次数，也减少手术次数。

Objective To probe the repair effect of bone defect after getting rid of free bone in chronic osteomyelitis patients. Method Eighteen chronic osteomyelitis patients were reconstructed with vascularized fibula graft at one stage after getting rid of free bone and 2 cases were reconstructed with regional transplantation of pedic fibula after inflammable bone segment were exsected. Result Twenty chronic osteomyelitis patients who were treated with vascularized fibula graft or regional transplantation of pedic fibula after getting rid of free bone were followed up 3 - 6 months (mean 3. 5 months). The reconstructed bone unioned well,the inflammation of all bones near to joints were controlled; the repaired limbs achieved satisfactory function and outline. Conclusion The operation to reconstruct bone defect after getting rid of free bone in chronic osteomyelitis patients with vascularized fibula graft or regional transplantation of pedic fibula primerally is a good method' The advantage lies in avoiding the long alteration period of free bone, bettering the blood circulation of receipt region, controlling inflammation, shortening the resident period,times and operation times,and so. The method is a good attempt to repair inflammatory bone defect using vascularized bone graft.