吻合血管的骨移植及钛板内固定修复下颌骨缺损

目的 探讨吻合血管的游离髂骨或腓骨移植及钛板坚强内固定在修复下颌骨缺损中的临床应用效果。方法 选择7例以旋髂深动静脉为蒂的游离髂骨肌瓣和2例以腓动静脉为蒂的游离腓骨肌瓣修复9例下颌骨缺损，并用钛板坚强内固定，血管的动静脉蒂分别与颌外动静脉吻合。结果 9例术后2～4周经放射性核素锝亚甲基二磷酸盐(^99mTc MDP)扫描证实血供良好，移植骨成活。经6个月至3年随访，移植骨固位稳定。结论 吻合血管的骨移植及钛板内固定是修复下颌骨缺损的最佳选择之一。

Reconstruction of maxillary defect with vascularized bone graft and internal fixation of titanium plate

Objective To study clinical effect of transplantation with vascularized ilium bone and free fibulae, and internal fixation of titanium plate on reconstruction of maxillary defect. Methods Nine cases of maxillary defect were repaired by 7 iliac muscle flaps with deep circumflex iliac artery and vein, 2 cases of fibulae muscle flap with peroneal artery and vein, meanwhile, fixed internally by titanium plate. The vessels were anastomosed with arteria and vena maxillaries externa. Results Nine patients were confirmed by 99m TcMDP 2-4 weeks after operation that the supply of blood was well and the graft bones were survival. By follow-up from 6 months to 3 years after operation, the fixations of graft bones were good. Conclusion Vascularized bone graft and internal fixation of titanium plate is one of the best ways for reconstruction of maxillary defect.