儿童部分腓骨切除后对供侧肢体的影响  

Influence to the donor limb foll owing partial excision of fibula in chil dren

作　　者：贺西京[1] 李浩鹏[1] 王栋[1] 金辽沙[1] 兰斌尚[1] 张开放[1] 张迎刚 

机构地区：[1]西安交通大学第二医院,陕西西安710003 [2]宜君县医院

出　　处：《中国骨伤》2001年第3期133-135,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨部分腓骨切除后对儿童供侧肢体功能及形态的影响。方法　对 3～ 12岁患原发性腓骨近端骨巨细胞瘤、胫骨骨折骨缺损及股骨头坏死的儿童共 6 3例 ,经小腿前外侧入路行部分带血管腓骨切取术。术后随访 3～ 10年 ,用踝关节功能测定仪、运动负荷试验、胫腓骨及踝关节X线片测量及评价双侧肢体功能及形态。结果　无一例肢体发育障碍或发生坏死。腓深神经或腓浅神经损伤占 11% ,但多数在术后 3月内自行恢复 ,仅 2例留有持久腓浅神经损伤表现。做运动负荷试验后检查 30例病人中 2例轻度踝疼 ,1例有较明显的踝疼。随患儿身高的增加 ,供骨侧腓骨远近两残端逐渐增长 ,但缺损间隙不变。结论　儿童部分腓骨被切除以后 ,多数供侧肢体无严重并发症。 30例中有 3例踝部疼痛者与腓骨切除较长有关。远期腓骨缺损间隙相对变短 。ObjectiveTo study the influence of function and a ppearance of the donor limb after excisi ng a part of fibula in children.MethodsA part of fibula partly with blood vesse ls were excised from anterolateral leg i n 63 children of 3～12 years old,who suff ered from giant cell tumor of bone of fi bula,bone defects and femoral head necro si s.The cases were followed up for 3～10 ye ars for the study of ankle function followi ng partial resection of the fibula.The f unction and appearance of both low limbs were examined and evaluated by using de termination instrument of ankle function ,sport loading test and X ray film of ti bia and fibula and ankle joints.ResultsThere were no developmental disturbance and necrosis of limbs occurred in all ca ses followed.The injury rate of profound peroneal nerve or superficial peroneal nerve in operation was 11 percent,but ma ny cases could spontaneously recover in three months after operation.Only two ca ses remained continuous injury of superf icial peroneal nerve.Of 30 cases done sp ort loading test,2 patients had slight a nkle pain and 1 had obvious ankle pain.W ith growing,the remained two parts of th e fibula in donor limb could become long er,but the length of the empty part betw een them did not change.ConclusionNo serious complication occurred in dono r limbs of most children after excising a part of fibula.The ankle pain in 3 cas es was related to the excised length of fibula.The vacancy length left in the fi bula become shorter relatively long term after operation in children,which is be nefit to the stability of ankle joint of donor side in future.

关 键 词：骨移植 腓骨 并发症 儿童 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]