Flap combined with 3D printed microporous tianium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect
10.3760/cma.j.cn441206-20210908-00216
- VernacularTitle:皮瓣加3D打印微孔钛（钽）假体治疗下肢软组织缺损伴大段骨缺损
- Author:
Yongqing XU
1
;
Xinyu FAN
;
Teng WANG
;
Shaoquan PU
;
Chuan LI
;
Xingbo CAI
;
Yi CUI
;
Xiaoqing HE
;
Wei LIN
;
Yipeng WU
;
Jian SHI
;
Xia LI
;
Dewei ZHAO
;
Baoyi LIU
;
Qiang FENG
Author Information
1. 联勤保障部队第九二医院全军创伤骨科研究所，昆明 650032
- Keywords:
Surgical flap;
Prosthesis;
3D printed microporous titanium(tantalum);
Lower extremity;
Soft tissue defect;
Bone defect
- From:
Chinese Journal of Microsurgery
2022;45(1):21-27
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of flap combined with 3D printed microporous titanium(tantalum)prosthesis in the treatment of lower extremity soft tissue defect with large bone defect.Methods:From January 2019 to December 2020, 2 patients with large soft tissue defects on dorsal foot together with large metatarsal bone defect and 4 patients with soft tissue defects of calf with large tibial bone defect were treated. The areas of soft tissue defect were 5.0 cm×8.0 cm-15.0 cm×10.0 cm. The length of the bone defect were 3.8 cm to 7.0 cm, 5.75 cm in average. In the first stage, metatarsal bone defect or tibial bone defect was filled with vancomycin blended bone cement, meanwhile, soft tissue defect was repaired with anterolateral femoral flap(ALTF) with vascular anastomosis in 2 cases of feet, and local fascia flap was trans-positioned in 4 cases of lower extremity defects. The sizes of repairing flap were 6.0 cm×8.5 cm-16.0 cm×11.0 cm. Two to 7 months after the initial surgery, the customer designed microporous titanium prostheses were used(5 cases with microporous titanium and 1 with microporous tantalum) to repair the bone defects. The wound healing, the integration of metatarsal and tibial fractures with 3D printed microporous titanium(tantalum) prostheses, and the walking condition were observed after surgery. The follow-up lasted from 6 to 25 months, with an average of 12.7 months.Results:The wound healing in 5 patients was good. The patients stood on the foot in 2 months after surgery, started to walk with the assistance of crutch in 3 months after surgery, and took walk without assistance in 5-6 months after surgery. Good osseous integration were achieved. One diabetic patient had infection of foot wound 3 months after surgery. After removal of microporous titanium prosthesis and replacement of vancomycin blended interstitial substance of bone cement, the wound healed and the patient resumed walking.Conclusion:It is an effective method to encourage the patients to take early ambulation after the surgery for lower extremity soft tissue defect with large bone defect that was repaired by a flap and 3D printed microporous titanium(tantalum)prosthesis. Further observations are required to investigate the long-term efficacy, and the reduction of prosthesis infection rate requires further exploration.
