腓骨移植联合髂骨治疗胫骨长段骨缺损21例观察

The Observation of Grafting Fibula and Ilium in Treatment of Long Tibia Defect in 21 Cases

目的：探讨吻合血管游离腓骨移植联合髂骨取骨植骨手术治疗胫骨长段骨缺损的疗效、注意事项。方法：2009年4月至2013年10月，采用外固定支架固定吻合血管的游离腓骨移植联合髂骨取骨植骨治疗胫骨长段骨缺损患者共21例，均采用外固定支架固定吻合血管的游离腓骨移植联合髂骨取骨植骨及复合组织瓣的切取、移植。结果：21例胫骨长段骨缺损患者术后全部骨性愈合，平均愈合时间10周，经12～48个月随访，均未出现供腓骨侧下肢踝关节不稳定情况，植骨侧小腿胫骨均有不同程度的腓骨胫骨化，按照Enneking 评分系统患肢术后功能恢复平均为正常功能的85％。结论：对于胫骨长段骨缺损者可采用外固定支架固定吻合血管的游离腓骨移植联合髂骨取骨植骨治疗，其疗效确切，骨折愈合快，能有效恢复患肢的支撑和负重功能，但应严格掌握适应证。

Objective:To explore vascular anastomosis free fibula grafting combined with iliac crest bone grafting in treatment of long tibia defect .Methods:In April 2009 to October 2013,there was external fixation bracket of vascular anastomosis free fibula grafting combined with iliac crest bone grafting in treatment of 21 patients with long tibia defect .Results:The recovery of tibial defect were all good osseous healing postoperatively in 21 patients with long tibia defect ,The average healing time was of 10 weeks, Followed-up after 12 ~48 months,there was not the peroneal ankle instability of lateral lower limbs .All bone grafting lateral crus had some fibular ossification of tibia , Accorded to Enneking scoring system , the limb functional recovery were over 85% an average of normal function .Conclusion:The vascular anastomosis free fibula grafting combined with iliac crest bone grafting in treatment of long tibia defect are efficacy and rapid for fracture healing ,Can effectively restore the function of supporting and bear load .But should be used strictly .