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作者报告自1958年6月-1995年8月采用吻合血管的腓骨小头骨骺移植治疗先天性桡骨缺如患儿12例,年龄5岁-12岁,通过手术松解前臂桡侧挛缩的软组织,于尺骨弯曲角度最大处的封状面上斜形截骨,采用超骨膜切取的方法切取带腓动静、静脉的腓骨小头骨骺,吻合血管后移植于前臂桡骨缺损处.移植腓骨愈合时间为6周-18周,12例病人经10月-4年随(平均26个月),前臂长度均明显增长,手腕挠偏畸基本纠正,前臂及手腕功能明显改善.术后1年-2年进行彩色多普勒超声检查,12例移植腓骨均显示腓动静脉血液通畅;腓骨移植1年后摄片检查,未见骨密度增高或骨吸收现象,移植腓骨有不同程度增粗及增长,腓骨小头骨骺不同程度增粗,取得了满意疗效.作者认为吻合血管的腓骨小头骨位移植能很好的重建缺损的桡骨,恢复前臂长度,移植腓骨愈合快,成活率高,是治疗先天性桡骨缺如的一种较理想的方法.
The authors report from June 1958 - August 1995 with the use of vascular calcification of the fibula epiphyseal transplantation in the treatment of children with congenital absence of radial in 12 cases, aged 5 years old to 12 years old, by surgery to relieve forearm radial contracture of the soft tissue, The ulnar osteotomy on the sealing surface with the maximal bending angle of the ulna was performed. The epiphysis of the fibula of the fibular calf and vein was excised by periosteal dissection. The anastomosis of blood vessels was transplanted into the radial defect of the forearm. The healing time of the grafted fibula was 6 weeks to 18 weeks. The mean length of the forearm was significantly increased in 12 patients (mean 26 months) from October to April. The wrist flexion and deviation were basically corrected and the function of forearm and wrist was significantly improved. Color Doppler echocardiography was performed 1 year to 2 years after operation, and the fibula of 12 cases was transplanted. The fibroids were unobstructed after 1 year of fibula transplantation. There was no bone mineral density or bone resorption in the fibula Degree of thickening and growth, fibula epiphysis increased to varying degrees, and achieved satisfactory results. The authors believe that the vascular fibular head bone transplantation can well reconstruct the defect radius, restore the length of the forearm, graft fibula healing, high survival rate, is a better method for the treatment of congenital radial absence.