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asbryobvrz · Wysłany: Pon 14:30, 07 Mar 2011

High altitude on experimental fracture healing of histological changes

Chinese Medicine, 1980,60 (7): 385 ~ 388 [9] Lu Yu Pu editor. Practical Orthopedics [M] Beijing: People's Medical Publishing House, 1993,58. [10] Liu Xiaofan.高压氧医学 [M]. Guangzhou: Popular Science Press, Guangzhou Branch, 1957, l6. (Close your samples :1998-07-22) shifted the ipsilateral fibula with vascular pedicle surgical treatment of tibial bone defects with the same side of the 1987-1992 with vascularized fibula transfer for treatment of large tibial defects, 12 cases achieved better results. The clinical data of patients 1 l2 7 males and 5 female. Age of l0 ~ 27 years, mean l8.5 years. 4 cases of bone infection bone defects, trauma bone defects 3 down, 2 cases of giant bone cyst, fibrous dysplasia of bone in 3 cases. Bone length 4 ~ 14cm, the average 6.5cro. Vascular pedicle were selected along the line shift. In addition to the ipsilateral fibular graft, the ends were added for free iliac bone graft. 1 to 7 years follow-up, an average of 3 years. l2 grafts healed fibula all survived, of which 8 the 5th week of callus growth can be seen clearly. Avian bone time 7 ~ l5 weeks of Taiwan, with an average 115 weeks. All patients resumed weight-bearing limb function. Upon group 2 complications down, stretch for the common peroneal nerve injury, recovery after 3 to 4 weeks. 2 surgical methods using continuous epidural anesthesia supine position, the conventional set upper thigh pneumatic tourniquet. Before taking a small lateral longitudinal faded Exposed part of the tibial defect,[link widoczny dla zalogowanych], but to preserve tibial genetically related cycle. Removal of the lesion, and extended across part of the tibial bone marrow cavity 121 fine from the original cut and the gastrocnemius muscle gap peroneal deep cut arrows film. Blunt muscle separation gap,[link widoczny dla zalogowanych], the retractor can be clearly exposed on both sides of the fibula. Outside the periosteum with scissors cut along the fibula fibula long and short fibular muscle attachments on the muscle fibers, retaining lcm soft tissue. 2.5cm defect in the tibia is truncated at the upper and lower fibula. Out, the next pull off the fibula bone and cut between the membranes, attached to the fibula by repeatedly cutting the inside of the posterior tibial muscle and part of Zhu longus muscle fibers, exposure to peroneal artery and vein. And with the cut surface of the distal fibula ligation peroneal vessels, keeping the nourishing blood vessels to form a smooth line with vascularized fibula. Both ends of the fibular periosteal stripping as appropriate, anterograde movement to the tibial bone defect, into the tibia bone marrow cavity or for the stepped Taiwan. L ~ 2 respectively screws nails. Such as the fibula distal stump less than 10cm long, with long screws for the next tibiofibular arthrodesis. Visible surface of the fibula after opening the tourniquet cuff muscles obviously bleeding. Peroneal vessels must be no tension, no distortion, and visible blood vessels throb. Before and after surgery of gypsum: Shanghai Chinese Medicine Hospital Orthopedics, 200071 Zhijiang Dong Hu Road 274 fixed-prop, use plaster cast after stitches fixed. 3 to discuss the treatment of tibial defect difficult. L2 cases in this group 3 times before surgery surgery 2 down, 2 second operation in 5 cases. Large bone defects with autologous bone grafts, bone repair is not only a long time, and often bone absorption. 1974 raylot other free fibular graft was first reported, after a large number of free vascularized fibular graft were reported. Compared with the conventional bone graft with vascular pedicle bone graft in the blood circulation can be restored after transplantation of bone cells to maintain graft survival, so that the process of creeping substitution of the cave into a common platform fracture healing process, shorten the healing time to improve the efficacy of the graft but also has greater resistance to infection, the possibility of being absorbed is small. But with free vascularized bone graft to kiss Taiwan vessels, the operation is difficult, there may be at the expense of main blood vessels and other shortcomings by surgery often subject to certain restrictions. Therefore, conventional bone grafting in general surgery and compared with free fibular graft, the ipsilateral fibula with vascular pedicle translocation surgery has healed quickly, a large bone graft resistance to infection, less likely to be absorbed,[link widoczny dla zalogowanych], the advantages of simple and reliable procedure is to solve the large tibia good method to block bone defects. After partial resection of the fibula, the impact on the ankle joint stability has been a fellow orthopedic concerns. Fibula after resection of ankle instability,[link widoczny dla zalogowanych], caused by the lateral move widened hole caused by the ankle. Rate group of patients for the fat only on the lateral shift of the fibula stump shorter than 10cm were made under tibiofibular arthrodesis. At the same time from the lower leg and ankle anatomy and physiology characteristics point of view, there is a strong lower fibula ligament,[link widoczny dla zalogowanych], joint capsule, and interosseous membrane, may restrict lateral move. Rate group of patients after follow-up results showed no effect of ankle joint function. 2 patients had common peroneal nerve traction injury. Because of intraoperative traction fibula when exposed peroneal muscle peroneal nerve is damaged. So be gentle surgery operation. Fibula with vascular pedicle of the shift is a survival of biological activity of bone, the fibula bone reconstruction after shifting through the obvious morphological changes occur, so that shift fibula becomes thick. As an alternative to weight-bearing tibia limb function recovery (Received :1998.10-2 Cool