CAJ | 학술논문

背景：研究表明，带血管腓骨移植是修复四肢大段骨缺损的有效方法之一。目的：分析带血管腓骨移植修复四肢大段骨缺损的临床效果。方法：采用腓骨移植修复四肢大段骨缺损病例中选择非恶性肿瘤、随访20个月以上病例28例，清除病灶后应用带血管腓骨移植修复大段骨缺损，对于合并软组织缺损的病例同时用腓骨皮瓣或股前外侧皮瓣覆盖。结果与结论：所有病例随访20个月至6年，移植腓骨后3-8个月与受区骨达到骨愈合，术后10-22个月移植腓骨直径增粗致接近受区骨直径。Enneking系统评价肢体功能：胫骨大段骨缺损平均24.2分，肢体功能恢复81%，患者对手术满意程度达94%；股骨骨缺损平均26.3分，肢体功能恢复88%，患者对手术满意程度100%；桡尺骨远端骨缺损平均21.75分，肢体功能恢复72%，患者对手术满意程度100%。结果表明应用带血管腓骨移植修复四肢大段骨缺损可有效促进骨缺损愈合，降低致残、感染及截肢率，治疗后患者对肢体功能恢复满意。
배경：연구표명，대혈관비골이식시수복사지대단골결손적유효방법지일。목적：분석대혈관비골이식수복사지대단골결손적림상효과。방법：채용비골이식수복사지대단골결손병례중선택비악성종류、수방20개월이상병례28례，청제병조후응용대혈관비골이식수복대단골결손，대우합병연조직결손적병례동시용비골피판혹고전외측피판복개。결과여결론：소유병례수방20개월지6년，이식비골후3-8개월여수구골체도골유합，술후10-22개월이식비골직경증조치접근수구골직경。Enneking계통평개지체공능：경골대단골결손평균24.2분，지체공능회복81%，환자대수술만의정도체94%；고골골결손평균26.3분，지체공능회복88%，환자대수술만의정도100%；뇨척골원단골결손평균21.75분，지체공능회복72%，환자대수술만의정도100%。결과표명응용대혈관비골이식수복사지대단골결손가유효촉진골결손유합，강저치잔、감염급절지솔，치료후환자대지체공능회복만의。
BACKGROUND:Vascularuzed fibular graft is one of the effective methods for repair of large segmental bone defects in the extremities OBJECTIVE:To explore the clinical effects of vascularized fibular graft for repairing large segmental bone defects in the extremities. METHODS:Twenty-eight non-malignant patients who received vascularized fibular graft for repairing large segmental bone defects in the extremities and were folowed up for more than 20 months were enroled. After lesion removal, vascularized fibula bone graft was used to repair the bone defects. If cases combined with soft tissue defects, fibula flap or anterolateral thigh flap was adopted. RESULTS AND CONCLUSION: Al patients were folowed up for 20 months to 6 years. The grafted bones were healed with the surrounding bone at 3-8 months after fibula bone grafting. The grafted bone was enlarged near to the diameter of recipient bone at 10-22 months after grafting. Based on the Enneking system, the average score of large segmental tibia bone defects was 24.2 points with 81% limb function recovered and 94.1% patient satisfaction; the average score of large segmental femur bone defects was 26.3 points with 87.7% limb function recovered and 100% patient satisfaction; the average score of large segmental bone defects of the distal radius and ulna was 21.75 points with 72.5% limb function recovered and 100% patient satisfaction. These findings reveal that vascularized fibular graft for repairing large segmental bone defects in extremities can effectively promote bone healing and reduce disability, infection, amputation rate; moreover, patients are satisfied with the postoperative recovery of limb function.