吻合血管的双腓骨并联移植修复长段股骨缺损  

REPAIR OF LONG SEGMENT BONE DEFECT OF FEMUR BY FREE JUXTAPOSED BILATERAL FIBULAE AUTOGRAFT

作　　者：杨志明[1] 黄富国[1] 郭祖艳[1] 裴福兴[1] 李箭[1] 

机构地区：[1]华西医科大学附属第一医院骨科

出　　处：《中国修复重建外科杂志》1997年第6期382-384,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：股骨干长段缺损的修复较为困难，过去有采用吻合血管的单根腓骨移植、双腓骨折叠移植以及组合移植等方法。１９９５年１２月，采用了吻合血管的自体双腓骨并联移植，将双侧腓骨滋养血管的对侧缘剥离部分骨膜袖，使双腓骨裸露骨面对合后，缝合骨膜袖，重建并联后的腓骨血循环，修复一例４岁儿童股骨缺损８ｃｍ。术后随访１年１０个月，并联腓骨融合成为一根直径与自体股骨相当的新骨，骨髓腔与股骨相通。这种技术可用于修复肱骨、胫骨、股骨干及股骨下段、胫骨上段肿瘤切除后的长段缺损。There were several methods, such as free single and folded fibulae autograft, composed tissue autograft, however, it is still very difficult to repair long segment bone defect. In December 1995, we used free juxtaposed bilateral fibulae autograft to repair an 8 cm of femoral bone defect in a 4 years old child in success. The key procedure is to strip a portion of the neighboring periosteal sleeve of juxtaposed fibulae to make bare of the opposite sides of the bone shafts, suture the opposite periosteal sleeves, keep the nutrient arteries, and reconstruct the blood circulation of both fibular by anastomosis of the distal ends of one fibular artery and vein to the proximal ends of the other fibular artery and vein, and anastomosis of the proximal ends of the fibular artery and vein to lateral circumflex artery and vein. After 22 months follow up, the two shafts of juxtaposed fibulae fused into one new bone shaft. The diameter of the new bone shaft was nearly the same as the diameter of the femur. There was only one medullary cavity, and it connected to the medullary cavity of femur. This method also cold be used to repair other long segment bone defect.

关 键 词：股骨干缺损 腓骨移植 并联移植 吻合血管 

分 类 号：R681.805[医药卫生—骨科学] R687.34[医药卫生—外科学]