A two-stage but time-saving reconstructive scheme to treat severe lower limb length discrepancy:Two case reports  

作　　者：Zhen Shi Qifeng Ou Cheng Li Yue Li Bo Wang Gechang Cheng Yimin Fan Qi Bao Juyu Tang 

机构地区：[1]Department of Plastic and Reconstructive Surgery,School of Medicine,Second Affiliated Hospital of Zhejiang University,Hangzhou 310009,Zhejiang,China [2]Department of Hand and Microsurgery,Xiangya Hospital,Central South University,Changsha 410008,Hunan,China [3]Institute of Pharmacology and Toxicology,Zhejiang University,Hangzhou 310030,Zhejiang,China [4]Department of Forensic Medicine of Hainan Medical University,Academician Workstation of Hainan Province(Tropical Forensic Medicine),Hainan Medical University,Haikou 571199,Hainan,China

出　　处：《Chinese Journal of Plastic and Reconstructive Surgery》2023年第2期68-72,共5页

基　　金：supported by the National Nature Science Foundation(grant nos.81871577 and 81971864)。

摘　　要：Limb length discrepancy(LLD)is a common orthopedic condition that can result in significant functional impairment,pain,and cosmetic deformities.Current reconstructive techniques for severe LLD are primarily based on callus distraction,which is a time-consuming process that can lead to complications,such as significant infection,joint stiffness,and stress fractures.To reduce the therapeutic time and minimize the risk of complications,we investigated the use of vascularized bone flaps as a technical supplement to callus distraction in the reconstruction of short limbs.We present two cases of severe LLD in the upper and lower legs,in which a twostage reconstruction approach was used.In the first stage,external fixation was applied to the affected limb to correct the soft tissue length and convert the short deformity into a bone defect.In the second stage,the bone defect was reconstructed using bilateral(patient A)or unilateral(patient B)free vascularized fibula bone grafts.Both patients had complete survival of the fibular grafts without stress fractures,and bone consolidation took 8 months(patient A)and 4 months(patient B).Compared to the traditional callus distraction,the two-stage approach was found to be more time-saving and reliable.The entire reconstructive scheme required 18 and 4 months for patients A and B,respectively,whereas the traditional callus distraction required 41 and 17 months,respectively.These findings suggest that the use of vascularized bone flaps as a technical supplement for callus distraction may provide an effective and efficient alternative for the treatment of severe LLD.Further studies are needed to validate these results and assess the long-term outcomes of this approach.

关 键 词：Limb length discrepancy Callus distraction Distraction osteogenesis Fibular graft Two-stage reconstruction 

分 类 号：R687.3[医药卫生—骨科学]