吻合血管腓骨段移植修复前臂大段骨缺损  

Reconstruction of bone defects of forearm using free vascularized fibular grafts

作　　者：高顺红[1] 倪玉龙[1] 于志亮[1] 符健松 董惠双[1] 张云鹏[1] 

机构地区：[1]唐山市第二医院(华北理工大学附属骨科医院)手外二科,063000

出　　处：《中华整形外科杂志》2017年第3期183-186,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨吻合血管腓骨移植修复前臂大段骨缺损的疗效。方法采用吻合血管腓骨移植修复尺、桡骨大段骨缺损22例，对其中6例伴有皮肤缺损者，采用腓骨骨皮瓣修复。尺骨缺损范围4～12cm，桡骨缺损范围5—14em。移植腓骨长度13～24cm，切取皮瓣面积为12cm×6cm～20cm×11cm。结果移植腓骨全部骨性愈合，愈合时间3～6个月，平均4．5个月。切口一期愈合，6例皮瓣均成活，质地柔软。患者均获12～26个月随访，平均14．5个月。患肢无移植骨再骨折，供区踝关节活动正常，小腿皮肤感觉无异常。参照Anderson评分标准，评定前臂旋转功能及肘、腕关节屈伸功能：优9例，良11例，可2例，优良率为90．9％。结论带血管蒂腓骨移植是修复前臂大段骨缺损的有效方法。Objective To investigate the clinical effect of reconstruction of bone defects of forearm using free vascularized fibular grafts （VFG）. Methods 22 patients with bone defects of forearm were treated with free VFG. 6 cases with upper limb bone and soft tissue defects were repaired with free vascularized osteoseptocutaneous fibula as a composite flap. The length of ulna defect ranged from 4 cm to 12 cm and radius defect from 5 cm to 14 cm. The length of harvested fibula ranged from 13 cm to 24 cm. The area of the skin flaps ranged from 12 cmx 6 cm to 20 cm x 11 cm. Results All graft bone achieved bone union, with the healing time from 3 to 6 months （mean, 4.5 months）. The operation incision healed primarily and all flaps survived with soft texture. All patients were followed up for 12 -26 months （mean, 20.5 months）. The function of forearm was recovered without refracture. The movement of ankle and the sensation in the leg were normal. According to the Anderson standard at last follow-up visit, the results were excellent in 9 cases, good in 11 cases and fair in 2 cases, with an excellent and good rate of 90.9%. Conclusions Vascularized fibular grafts VFG is an effective method to repair bone defects of forearm.

关 键 词：腓骨 组织移植 前臂 显微外科手术 

分 类 号：R658.2[医药卫生—外科学]