A two-stage but time-saving reconstructive scheme to treat severe lower limb length discrepancy:Two case reports

作     者：Zhen Shi Qifeng Ou Cheng Li Yue Li Bo Wang Gechang Cheng Yimin Fan Qi Bao Juyu Tang Zhen Shi;Qifeng Ou;Cheng Li;Yue Li;Bo Wang;Gechang Cheng;Yimin Fan;Qi Bao;Juyu Tang

作者机构：Department of Plastic and Reconstructive SurgerySchool of MedicineSecond Affiliated Hospital of Zhejiang UniversityHangzhou 310009ZhejiangChina Department of Hand and MicrosurgeryXiangya HospitalCentral South UniversityChangsha 410008HunanChina Institute of Pharmacology and ToxicologyZhejiang UniversityHangzhou 310030ZhejiangChina Department of Forensic Medicine of Hainan Medical UniversityAcademician Workstation of Hainan Province(Tropical Forensic Medicine)Hainan Medical UniversityHaikou 571199HainanChina 

出 版 物：《Chinese Journal of Plastic and Reconstructive Surgery》 (Chinese Journal of Plastic and Reconstructive Surgery)

年 卷 期：2023年第5卷第2期

页      面：68-72页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the National Nature Science Foundation(grant nos.81871577 and 81971864) 

主　　题：Limb length discrepancy Callus distraction Distraction osteogenesis Fibular graft Two-stage reconstruction 

摘      要：Limb length discrepancy(LLD)is a common orthopedic condition that can result in significant functional impairment,pain,and cosmetic *** reconstructive techniques for severe LLD are primarily based on callus distraction,which is a time-consuming process that can lead to complications,such as significant infection,joint stiffness,and stress *** reduce the therapeutic time and minimize the risk of complications,we investigated the use of vascularized bone flaps as a technical supplement to callus distraction in the reconstruction of short *** present two cases of severe LLD in the upper and lower legs,in which a twostage reconstruction approach was *** the first stage,external fixation was applied to the affected limb to correct the soft tissue length and convert the short deformity into a bone *** the second stage,the bone defect was reconstructed using bilateral(patient A)or unilateral(patient B)free vascularized fibula bone *** patients had complete survival of the fibular grafts without stress fractures,and bone consolidation took 8 months(patient A)and 4 months(patient B).Compared to the traditional callus distraction,the two-stage approach was found to be more time-saving and *** entire reconstructive scheme required 18 and 4 months for patients A and B,respectively,whereas the traditional callus distraction required 41 and 17 months,*** findings suggest that the use of vascularized bone flaps as a technical supplement for callus distraction may provide an effective and efficient alternative for the treatment of severe *** studies are needed to validate these results and assess the long-term outcomes of this approach.