吻合血管游离双侧腓骨组合移植修复股骨大段缺损

Repair of segmental femoral defect by combined transplantation of bilateral vascularized fibulas

目的 报道应用吻合血管双侧游离腓骨组合移植修复股骨节段性缺损的技术和效果。 方法 在 1984年 10月～ 1992年 5月间 ,应用吻合血管游离移植双侧腓骨治疗了股骨缺损 9例 ,其中5例为骨肿瘤 ,3例为慢性骨髓炎后病理性骨折 ,1例为创伤性骨缺损。移植腓骨长 12～ 2 2cm ,平均16 2 5cm。 结果 除 1例术后 6个月因软骨肉瘤复发而截肢外 ,移植腓骨均于术后 3～ 6个月与宿主骨牢固连接 ,患肢术后 3～ 7个月开始负重。 结论 吻合血管双侧游离腓骨组合移植修复 10cm以上股骨缺损 ,疗程短 ,效果好 ,是个可供选择的治疗方法。

Objective To report the technique and outcome of combined transplantation of bilateral vascularized fibulas to repair the segmental femoral defect Method In the period from October 1984 to May 1992, bilateral vascularized fibula transfer was done to treat femoral defects in 9 cases, in which there were 5 cases of bone tumor, 3 cases of pathological fractures following chronic osteomyelitis and 1 case of posttraumatic bone defect The length of the transferred fibulas ranged from 12 cm to 22 cm and averaged 16.25 cm Result Except 1 case in which thigh amputation was done 6 months after operation because of local recurrence of the chondrosarcoma, all the transferred fibulas united solidly with the host bones 3-6 months after operation The repaired limbs started weight-bearing at the third to seventh postoperative month Conclusion To repair a femoral defect over 10 cm in length, combined transfer of bilateral vascularized fibulas is the treatment of choice with short therapeutic process and good results.