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首页> 外文期刊>Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology >Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection
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Pedicled vascularized fibular graft with Ilizarov external fixator for reconstructing a large bone defect of the tibia after tumor resection

机译：带蒂带血管的腓骨腓骨移植带Ilizarov外固定器，可在肿瘤切除后重建胫骨的大骨缺损

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class="Heading">Background class="Para">Large bony defects in the middle or distal third of the tibia resulting from surgical resection of malignant bone tumors present a difficult reconstructive challenge. Various methods of reconstruction are available, such as allografts, vascularized fibular graft (either free or pedicled), or endoprothesis replacement for distal defects. class="Heading">Materials and methods class="Para">Twelve patients—eight males and four females with mean age of 18?years at operation (range 14–25?years)—with malignant bone tumors of the tibial shaft were selected as candidates for wide resection of the tumor and reconstruction of the bony defect by ipsilateral vascularized fibular graft based on the peroneal vessels. Preoperative staging studies, including plain radiography, local MRI, isotopic bone scan, and chest CT, were done for every patient before biopsy. Ilizarov external fixation was then applied in all cases. The average length of the bony gap bridged was 14.5?cm (13–16.5?cm) and the mean length of the harvested graft was 16.3?cm (15–18?cm). The average operation time was 7.5?h (5.5–9.5?h). class="Heading">Results class="Para">The mean follow-up period was 38?months (range 32–52?months). Bony union at the proximal and distal ends of the fibula occurred in nine patients (75?%) and at a mean time of 5.5?months (range 4.5–8?months). Graft hypertrophy occurred in all patients. The mean percentage of hypertrophy was 95?% (range 80–160?%). The mean MSTS functional score was 84?% (range 80–92?%). A leg length discrepancy of 2?cm was reported in two patients and was managed using a shoe lift. class="Heading">Conclusion class="Para">Reconstruction of bony defects of the middle or distal tibia after bone tumor resection using pedicled vascularized fibula is a useful limb salvage procedure. The procedure can be performed relatively quickly and inexpensively and has a low rate of late complications. It leads to a good outcome regarding the union, hypertrophy, and function.
机译：class =“ Heading”>背景 class =“ Para”>由于手术切除恶性骨肿瘤而导致的胫骨中部或远端三分之一的大骨缺损，给重建带来了挑战。可以采用多种重建方法，例如同种异体移植，带血管的腓骨移植（游离或带蒂）或用于远端缺损的人工关节置换术。 class =“ Heading”>材料和方法 类=“ 12例患者，其中8例男性和4例女性，平均手术年龄18？岁（范围14–25？岁）–胫骨干恶性骨肿瘤被选为广泛切除肿瘤的候选者，同侧血管化腓骨移植重建腓骨缺损。活检前对每位患者进行术前分期研究，包括X线平片，局部MRI，同位素骨扫描和胸部CT。然后将Ilizarov外固定架用于所有情况。桥接的骨间隙平均长度为14.5？cm（13-16.5？cm），收获的移植物的平均长度为16.3？cm（15-18？cm）。平均手术时间为7.5？h（5.5-9.5？h）。 class =“ Heading”>结果 class =“ Para”>平均随访时间为38？月（范围32-52？months）。 9名患者（75％）发生在腓骨近端和远端的骨结合，平均时间为5.5个月（4.5-8个月）。所有患者均发生移植物肥大。肥大的平均百分比为95％（范围80-160％）。平均MSTS功能评分为84％（范围80-92％）。据报道，两名患者的腿长差异为2？cm，并通过换鞋进行处理。 class =“ Heading”>结论 class =“ Para”>骨缺损的修复使用带蒂的血管化腓骨切除骨肿瘤后的中胫骨或远端胫骨是一种有用的肢体挽救方法。该过程可以相对快速和廉价地进行，并且后期并发症的发生率低。可以在结合，肥大和功能方面取得良好的结果。

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