Recently we have been performing biological reconstruction for malignant bone tumors of the extremities using frozen autografts. Here we present a case treated with free vascularized fibular graft (FVFG) after this me...Recently we have been performing biological reconstruction for malignant bone tumors of the extremities using frozen autografts. Here we present a case treated with free vascularized fibular graft (FVFG) after this method. A 23-year-old man developed osteosarcoma in his left distal tibia. There was nonunion after frozen autograft reconstruction, which we treated with FVFG. Twenty-four months later, bridging between the host bone and the frozen autograft was achieved. Our department has achieved bone union in almost all cases, but we sometimes encounter cases of nonunion after this method because of delayed blood supply. In these instances, reconstruction using FVFG may represent an attractive choice for salvage treatment.展开更多
The internal fixation failure for treatment of femoral neck fracture is mainly due to improper fixation, loss of fixation stability and premature ambulation. Bone nonunion and avascular osteonecrosis of the femoral he...The internal fixation failure for treatment of femoral neck fracture is mainly due to improper fixation, loss of fixation stability and premature ambulation. Bone nonunion and avascular osteonecrosis of the femoral head caused by the internal fixation failure for femoral neck fracture are always the complex topics in orthopedics. With regard to patients who sustain these complications, total hip arthroplasty is a proper choice for elderly patients, but is not acceptable by young patients. We report nine patients with the failure of internal fixation for femoral neck fracture who were treated with free vascularized fibular grafting and internal fixation with cannulated screw from November 2001 to October 2003. All of them achieved good results.展开更多
文摘Recently we have been performing biological reconstruction for malignant bone tumors of the extremities using frozen autografts. Here we present a case treated with free vascularized fibular graft (FVFG) after this method. A 23-year-old man developed osteosarcoma in his left distal tibia. There was nonunion after frozen autograft reconstruction, which we treated with FVFG. Twenty-four months later, bridging between the host bone and the frozen autograft was achieved. Our department has achieved bone union in almost all cases, but we sometimes encounter cases of nonunion after this method because of delayed blood supply. In these instances, reconstruction using FVFG may represent an attractive choice for salvage treatment.
文摘The internal fixation failure for treatment of femoral neck fracture is mainly due to improper fixation, loss of fixation stability and premature ambulation. Bone nonunion and avascular osteonecrosis of the femoral head caused by the internal fixation failure for femoral neck fracture are always the complex topics in orthopedics. With regard to patients who sustain these complications, total hip arthroplasty is a proper choice for elderly patients, but is not acceptable by young patients. We report nine patients with the failure of internal fixation for femoral neck fracture who were treated with free vascularized fibular grafting and internal fixation with cannulated screw from November 2001 to October 2003. All of them achieved good results.
文摘目的总结吻合血管游离腓骨移植(free vascularized fibular grafting,FVFG)治疗股骨头缺血性坏死(osteonecrosis of femoral head,ONFH)的临床技术,以及改进的手术器械在术中应用价值。方法2011年3月—2013年1月,采用改进的手术器械行FVFG治疗ONFH患者35例(47髋)。男24例(32髋),女11例(15髋);年龄22~43岁,平均34岁。单髋23例,双髋12例。病程5~9个月,平均7个月。ONFH类型:酒精性25髋,激素性12髋,创伤性3髋,特发性7髋。术前行X线片检查,根据国际骨循环协会(ARCO)分期标准:Ⅰ期3髋,Ⅱ期39髋,Ⅲ期5髋。术前髋关节Harris评分为(58.2±6.1)分。结果术中切取腓骨时间为15~35 min,平均25 min;手术时间90~200 min,平均130 min。术中出血量为150~500 m L,平均270 m L。术后切口均Ⅰ期愈合,无感染、下肢深静脉血栓形成等并发症发生。患者均获随访,随访时间12~42个月,平均28个月。末次随访时Harris评分为(87.3±5.7)分,较术前显著提高,比较差异有统计学意义(t=102.038,P=0.000)。X线片复查示,腓骨瓣位置良好,末次随访时股骨头坏死改善9髋,无进展36髋,进展2髋。结论采用FVFG治疗ONFH能有效改善患者髋关节功能,术中应用改进的手术器械能提高手术效率。
