3D对比打印腓骨头复合组织瓣移植精准修复肢体组织缺损九例  

Precision repairing of compound tissue defect at limbs by 3-Dimentional contrast printing and fibular head compound tissue flap transplantation

作　　者：欧学海[1] 胡雷鸣[1] 史少岩 张丽君[1] 魏登科[1] 李晓旭 Ou Xuehai;Hu Leiming;Shi Shaoyan;Zhang Lijun;Wei Dengke;Li Xiaoxu(Ward Area I,Hand Surgery Department,Honghui Hospital,Affiliated to Xi'an Jiaotong University,Xi'an 710054,)

机构地区：[1]西安交通大学医学院附属红会医院手外科一病区,710054

出　　处：《中华显微外科杂志》2019年第2期128-131,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨利用3D对比打印技术结合腓骨头复合组织瓣移植精准修复肢体组织缺损的临床应用。方法自2014年3月至2017年9月,对于肢体骨关节部位合并骨缺损及软组织缺损9例,其中桡骨远端骨合并关节囊及韧带缺损2例,股骨下段及胫骨下段骨和软组织缺损各2例,内踝骨和韧带缺损2例,外踝骨和韧带缺损1例。术前采用3D打印,双侧镜像对比,获取关节处或者肢体骨组织缺损形态,依据打印出的组织形态于供区切取相应的带血管的腓骨或腓骨头复合组织块,将组织块移植于受区,吻合血管,恢复移植组织的血供。术后定期随访。结果9例移植复合组织块成活;供区及受取创面一期愈合,随访9~35(平均17.5)个月,踝关节参照Kofoed评分标准优2例,良1例;修复2例上肢腕关节,参照Mayo腕关节评分标准评分优1例,良1例;修复股骨及胫骨术后6个月达到骨性愈合,患肢负重行走;修复肢体功能恢复,患者对疗效满意。结论采用3D对比打印腓骨头复合组织及腓骨复合组织瓣移植修复肢体复合组织缺损,可以减少供区损伤,达到精准修复,且术后肢体功能恢复良好。Objective To explore the clinical application and effect of fibular head compound soft tissue flap transplantation on precision repairing of compound tissue defect at limb joints assisted by 3-Dimensional contrast printing technology.Methods From March,2014 to September,2017,9 patients with bone and soft tissue defect at limb joints were selected.In which,2 were distal radius bone defect with joint capsule and ligament defect,2 were lower segment tibia bone and soft tissue defect,2 were femur under section of the bone and soft tissue defect,2 were medial malleolus bone and ligament defect,and 1 was external ankle ligament and bone defect.Using 3-Dimensional printing to conduct bilateral mirror-image contrast prior to the operation,morphology of bone defect at limb joints was acquired.Based on the texture printed out,corresponding fibular head compound blocks with blood vessels were removed from the donor site and transplanted to the recipient site before anastomosing the blood vessels and restoring the blood flow.The regular post-operative followed-up was performed.Results The 9 transplanted tissue blocks survived.The donor sites and the recipient sites were healed.The followed-up for restoration of limb function was from 9 to 35(average,17.5)months.The ankle function was assessed according Kofoed scale,resulted in 2 excellent and 1 good;The wrist function was assessed according Mayo scale,resulted in 1 excellent and 1 good.The medial malleolus bone defect and criteria bone defect were healed at 6 months.The patients were satisfied with the efficacy.Conclusion The application of 3-Dimensional contrast printing of fibular head compound tissue flap transplantation in repairing compound tissue defects at limb joints can reduce damage to the donor site,realizing precise repairing on limb tissue defect,and make good function restoration.

关 键 词：腓骨头移植 3D打印 组织缺损 修复 显微外科技术 

分 类 号：R658[医药卫生—外科学]