Revision Tibial Lengthening in a Leg Length Discrepancy Patient with Autogenous Fibula Structure Cortical Bone Graft and Internal Plate Fixation without Associated External Fixator: A Cases Report

脛骨延長術後雙腳長度不等長之病患使用自體腓骨結構性皮質骨移植物及內固定方式而不需使用外固定器進行脛骨再次延長術：病例報告

曾俊翔(Chun-Hsiang Tseng) ； 史瑞田(Jui-Tein Shih)

《南臺灣醫學雜誌》 15卷1期 (2019/06) Pp. 62-67

https://doi.org/10.6726/MJST.201906_15(1).0007

摘要

We present a case in which a patient had leg length discrepancy of about 3 cm due to an old fracture of the tibia with malunion. After two failures in lengthening surgery with a broken plate, he came to our hospital for help. We removed the implant, and lengthened his tibia with an autogenous fibular structure cortical bone graft, and iliac crest cancellous bone graft. Then we used two locking compression plates (LCPs) bilaterally for fixation. After near 6 months' follow-up, the radiograph shows callus formation at the lengthening site, and the patient almost can't feel the length in-equality between the two legs. The operation is satisfactory, without complications except a superficial surgical wound infection 1 month after surgery.

關鍵字

leg length discrepancy ； autogenous fibular structure bone graft ； tibial lengthening ； internal fixation

並列摘要

我們提出一個病例，由於脛骨陳舊性骨折伴有癒合不正，造成病患的雙腿長度差異約為3公分。在兩次延長手術失敗及鋼板斷裂後，他來到我們醫院尋求幫助。我們移除了植入物，並使用自體腓骨結構性皮質骨移植物和髂嵴鬆質骨移植物延長了他的脛骨。接著我們在雙側使用兩個鎖定式加壓鋼板（LCP）進行固定。在近6個月的追蹤後，X光片顯示在延長部位形成骨痂，患者幾乎感覺不到兩腿之間的長度差異。除手術過後1個月時的表淺手術傷口感染外，沒有其他併發症，手術效果良好。

並列關鍵字

雙腿長度差異 ； 自體腓骨結構性移植 ； 脛骨延長術 ； 內固定