摘要
目的探讨带血管蒂腓骨移植治疗胫骨骨髓炎并骨缺损的效果。方法1990～2001年对36例胫骨骨髓炎并骨缺损的患者采用健侧(19例)和患侧(17例)带血管蒂腓骨移植(位)治疗,术后随访1～11年。参照Enneking系统对患肢进行功能评价,以正常肢体功能的百分数表示,对移植腓骨的转归,参照国际挽救肢体讨论会上制定的“同种及带血管骨移植放射学评价方法”进行评价。结果取健侧腓骨移植的患肢功能平均恢复86%,移植腓骨平均愈合时间为15周;骨髓炎复发1例,骨折及骨延迟愈合2例,平均41周移植骨明显变粗;取患侧腓骨移位的患肢功能平均恢复78%,移植腓骨平均愈合时间为16周;骨髓炎复发1例,骨折及骨延迟愈合3例,平均43周移植骨明显变粗;两组患肢功能恢复比较有统计学意义(P=0.041)。结论带血管蒂腓骨移植(位)是治疗胫骨骨髓炎并骨缺损的较好方法,健侧腓骨移植功能恢复优于患侧。
Objective To study the effect of repair of the osteomyelitis complicated with bone defects in tibia with vascularized fibula transfers. Meth ods From 1990 to 2001,thirty-six cases of the osteomyelitis complicated with bo ne defects in tibia were treated with vascularized fibula transfers. Among them 19 cases were repaired with vascularized fibula grafting from the other side and other 17 cases were repaired with grafting from the same side. They were follow ed up for 1 to 11 years. The functions of the operated limbs were evaluated acco rding to Enneking Score System, and the outcomes of the fibula grafts were asses sed by radiographic examination with reference to the criteria established by In ternational Symposium on Limb Salvage. Results The average recovery rate of the operated limbs in those repaired by the other side grafting was 86%, and the av erage healing period of the fibula graft was 15 weeks. The osteomyelitis recurre d in 1 case and fracture of the graft and delayed healing occurred in 2 cases. T heir fibula grafts were observed to get thickened in 41 weeks on average. While in those repaired by the same side grafting, the average recovery rate of the op erated limbs was 78%. Their average healing period of the fibula graft was 16 w eeks. The osteomyelitis recurred in 1 case and fracture of the graft and delayed healing occurred in 3 cases. The fibula grafts were observed to get thickened i n 43 weeks on average. There was a statistically significant difference between the differently treated cases(P=0.041). Conclusion It is a good choice to tre at the osteomyelitis complicated with bone defects in tibia by vascularized fibu la grafting, and the vascularized fibula graft from the other side is better tha n that from the same side because of better functional recovery of the operated limb.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第2期237-239,共3页
Chinese Journal of Orthopaedic Trauma
