吻合血管的游离腓骨移植修复桡骨远端骨缺损重建腕关节8例报告  

Reconstruction of the distal radius with vascularized fibula

作　　者：杜伍岭 李端峰 吕豪 华永新 刘培亭 王源瑞 孟祥海 

机构地区：[1]济南市心医院骨创显微外科,济南市250013

出　　处：《中国矫形外科杂志》2004年第16期1232-1235,共4页Orthopedic Journal of China

摘　　要：目的 :评价吻合血管的游离腓骨移植重建骨巨细胞瘤切除后桡骨远端的可行性和疗效。方法 :将带血管的腓骨近端用 2或 3枚螺钉固定于大块切除瘤体后的桡骨远端 ,腓动脉两端与切断的桡动脉远近两端吻合 ,腓静脉与皮静脉吻合。膝关节外侧副韧带和股二头肌腱固定于胫骨的适当位置。结果 :平均骨愈合时间 3 .5个月。 5例术后 1周桡动脉造影 ,证实吻合的腓动脉血流通畅。末发现患侧前臂有残留性疼痛及腕关节不稳。腕关节外形基本正常 ,主动运动良好 ,患侧手的握力均比较满意。结论 :本方法是目前治疗桡骨远端骨缺损。Objective: To evaluate the feasibility and effectiveness of vascularized fibula for reconstruction of the distal radius after giant-cell tumor was resected. Method: The harvested fibula with the peroneal vessels is fixed by two or three screws to the distal radius with GCTs had been removed. Both ends of the peroneal artery are anastomosed to the radial artery and peroneal vein are anastomosed to the cutaneous vein. Lateral collateral ligament of knee joint and tendon biceps femorls were fixed in the positive situation of the tibia. Result: Five of eight, the excellent blood flow of the radial artery through the bridged fibular artery to the hand were confirmed by angiography postoperatively. No residual pain or instability of the wrist were noted, and approximately normal configuration of the wrists was observed. Active moving of the carpus were better, and the grip strength of the hands on the involved side were satisfying. Conclusion: The grafting of vascularized proximal fibula is an ideal technology for treatment of large bone deficit in the distal radius.

关 键 词：骨巨细胞瘤 吻合血管的腓骨移植 腕关节重建 

分 类 号：R687[医药卫生—骨科学]