Free Fibular Flap for Reconstruction of Long-Bone Defects in Lower Extremities-Experiences in Kaohsiung Veterans General Hospital

腓骨游離骨皮瓣在下肢長骨缺損的重建－高雄榮總的經驗

嚴子禎(Tzu-Chen Yen) ； 陳理維(Lee-Wei Chen) ； 楊國強(Kuo-Chung Yang)

《中華民國整形外科醫學會雜誌》 18卷3期 (2009/09) Pp. 247-256

https://doi.org/10.7096/JPSA.200909.0247

摘要

背景：
下肢長骨缺損的重建對許多外科醫師來說是一大挑戰。需要帶血管莖之骨移植來達到足夠的重建。腓骨游離骨皮瓣是其中許多帶血管莖骨移植中最常被使用的一種。然而各種報告顯示它們有不同的骨癒合及併發症的比率。在這裡我們以8個案例題出我們對於骨癒合及併發症的經驗。
目標與主旨：
本篇文章旨在檢視我們使用腓骨游離骨皮瓣在下肢長骨缺損重建的結果。
材料與方法：
從2001年10月至2005年3月，10位下肢長骨缺損的病人在高雄榮民總醫院接受了腓骨游離骨皮瓣的重建手術。移植骨的接受處以股骨佔5位，脛骨佔5位。有8位病人使用雙支柱技術。平均的骨頭缺損長度為6.7公分。
結果：
所有手術皆順利成功，而最終骨頭癒合比率亦為100%。平均的癒合時間為7.6個月。術後併發症包括了延遲癒合有1位，以及有1位單骨支柱的移植骨骨折。在此系列病人中沒有較嚴重的捐贈區併發症。
結論：
腓骨游離骨皮瓣對於下肢長骨缺損的重建確實是可靠的方法，因為它有極佳的骨癒合率。而雙支柱技術對於避免術後移植骨之骨折有所幫助。

並列摘要

Background:
Reconstruction of long-bone defects in lower extremities is often a challenge to surgeons. It requires vascularized bone graft to achieve adequate reconstruction. Free fibular flap is the most commonly used option of vascularized bone grafts. However, bone union rate and complication rate were varied in reports. Here, we reported our experiences with bone union and complication in eight cases.
Aim and Objectives:
This study aims to examine the results of long-bone defect reconstructions with free fibular flaps at our center.
Materials and Methods:
Between October 2001 and March 2005, ten patients with segmental bony defects in lower extremities were reconstructed with free fibular flaps at Kaohsiung Veterans General Hospital. The recipient site was the femur in five cases and the tibia in five cases. Double-strut technique was applied in 8 patients. Two patients were excluded from this study due to loss of follow-up. The average length of bone defect was 6.7 cm.
Results:
There was no flap failure. The bone union rate was 100% with an average 7.6 months of union time. Postoperative complications included one delayed union and one graft fracture in a patient with a single strut fibula. There was no significant donor site morbidity in our series.
Conclusion:
Free fibular flap is reliable for reconstruction of long-bone defects in lower extremities with excellent bone union rate. Double-strut technique may help avoid postoperative graft fracture.

並列關鍵字

free fibular flap ； long-bone defect ； graft fracture