腓骨移植术33例分析

Vascular pedicled fibular graft for the treatment of bone defect in long bone of the limb.A report of 33 cases

目的 介绍我院 1981年 8月至 1999年 10月采用吻合血管的游离腓骨移植术修复四肢长骨干骨缺损 33例的手术治疗方法。方法 带血管蒂的游离腓骨移植至受区时 ,其动脉吻合采用动脉双口吻合法或叫“T”形嵌入端端吻合法 ;在带血管蒂的游离腓骨取材入路上作了简化。结果经随访 6个月至 5年 ,平均 2 5年 ,经X线摄片检查 ,术后移植骨临床愈合时间为 2～ 5个月 ,平均3 5个月。肢体功能基本恢复正常。结论 带血管蒂的游离腓骨移植是修复四肢长骨长段骨缺损的有效方法 ;在血管吻合时采用动脉“T”形嵌入端端吻合法 ,该法既保证移植骨的血供 ,又使受区供血动脉原供区血液供应不受影响 ,在带血管蒂的腓骨取材上 。

Objective To review 33 cases of bone defect in long bone of the limbs treated with vascular pedicled free fibular graft and vascular anastomosis from 1981.8 to 1999.10. Methods When free fibula with vessel pedicle was grafted to recipient region,arterial anastomosis was performed by arterial anastomosis or end-to-end anastomosis with 'T' shape insert.Results The follow-up period ranged from 6 months to 5 years,with an average of 2 5 years.The clinical union during of grafted bones ranged from 2 to 5 months,with an average of 3 5 months.The limb function nearly recovered to normal.Conclusion Grafting of fibula with vascular pedicle is an effective method to repair bone defect in long bone of the limb.End-to-end anastomosis with 'T' shape insert during vascular anastomosis ensures blood supply of grafted bone,and there is no side effects on blood supply of origin blood circulation.The operation is simple and the graft material is ready to be procured.