Research progress of surgical treatment for lateral malleolus defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Zheng ¹ ,  YU Aixi ^1,2

1. Department of Trauma and Microscopic Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan Hubei, 430071, P.R.China;
2. Center of Wuhan Clinical Medical Research of Microsurgery, Wuhan Hubei, 430071, P.R.China;

Corresponding author：

YU Aixi, Email: yuaixi666@163.com

Keywords：

Lateral malleolus defect; surgical treatment; research progress

DOI：

10.7507/1002-1892.201902047

Video：

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Objective To review the research progress of the surgical treatment for lateral malleolus defect.Methods The related literature about surgical treatment and effectiveness of lateral malleolus defect at home and abroad was reviewed, summarized, and analysed.Results Lateral malleolus defects are often caused by severe trauma or wide resection of fibular neoplasms. Although the incidence is not high, the defects are difficult to handle. These bony defects should be reconstructed to prevent an abnormal gait induced by ankle instability and avoid the occurrence of traumatic arthritis. Various repair methods have been developed, including bone transplantation, fibula lengthening, and ankle arthrodesis.Conclusion There are various surgical methods to repair the defect of lateral malleolus, but each has its own advantages and disadvantages. In order to achieve the best results, the surgeon should choose the appropriate operation according to his own level, the patient’s specific injury, and age.

Citation： WANG Zheng, YU Aixi. Research progress of surgical treatment for lateral malleolus defect. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(9): 1196-1199. doi: 10.7507/1002-1892.201902047 Copy

1.	俞立新, 马锁坤. 腓骨中段" Z”形截骨延长重建外踝一例. 中华显微外科杂志, 1997, 20(4): 250.
2.	Capanna R, van Horn JR, Biagini R, et al. Reconstruction after resection of the distal fibula for bone tumor. Acta Orthop Scand, 1986, 57(4): 290-294.
3.	Herring CL Jr, Hall RL, Goldner JL. Replacement of the lateral malleolus of the ankle joint with a reversed proximal fibular bone graft. Foot Ankle Int, 1997, 18(6): 317-323.
4.	Babhulkar SS, Pande KC, Babhulkar S. Ankle instability after fibular resection. J Bone Joint Surg (Br), 1995, 77(2): 258-261.
5.	马武秀. 自体骨移植修复骨缺损的研究进展. 中国骨与关节损伤杂志, 2011, 26(6): 574-576.
6.	左健, 康建敏, 潘乐. 胫骨下段大段瘤性骨缺损修复重建的研究进展. 中国修复重建外科杂志, 2018, 32(9): 1211-1217.
7.	苏瑞鉴, 曾麟杰, 陈善豪. 踝关节缺损的修复重建二例. 中国修复重建外科杂志, 2006, 20(11): 1155-1156.
8.	张岩, 蔡培华, 阮洪江, 等. 吻合血管的腓骨头联合皮瓣移植修复复杂外踝缺损. 中国修复重建外科杂志, 2008, 22(11): 1288-1291.
9.	Bibbo C, Ehrlich DA, Kovach SJ 3rd. Reconstruction of the pediatric lateral malleolus and physis by free microvascular transfer of the proximal fibular physis. J Foot Ankle Surg, 2015, 54(5): 994-1000.
10.	潘振宇, 喻爱喜, 张建华, 等. 带血管蒂腓骨头移植重建外踝的解剖及初步临床应用. 中华显微外科杂志, 2006, 29(5): 364-366.
11.	王树锋, 吕占辉, 王明山, 等. 带血供腓骨小头骨骺移植的解剖与临床研究. 中华骨科杂志, 2001, 21(2): 99-102.
12.	Tsai TM, Ludwig L, Tonkin M. Vascularized fibular epiphyseal transfer. A clinical study. Clin Orthop Relat Res, 1986, (210): 228-234.
13.	Rajacic N, Dashti H. Reconstruction of the lateral malleolus using a reverse-flow vascularized fibular head: a case report. Microsurgery, 1996, 17(3): 158-161.
14.	Bickels J, Kollender Y, Pritsch T, et al. Knee stability after resection of the proximal fibula. Clin Orthop Relat Res, 2007, 454: 198-201.
15.	李静东, 宋守礼, 朱盛修. 带血管蒂的腓骨(膜)逆行移位术的解剖学基础. 解放军医学杂志, 2000, 25(4): 266.
16.	刘云建, 沈扬. 带血管蒂腓骨逆行移位重建外踝五例. 中国修复重建外科杂志, 1994, 8(4): 226-227.
17.	de Gauzy JS, Kany J, Cahuzac JP. Distal fibular reconstruction with pedicled vascularized fibular head graft: a case report. J Pediatr Orthop B, 2002, 11(2): 176-180.
18.	Gao YS, Zhang CQ, Sheng JG. Reverse transfer of the proximal vascularized fibula to reconstruct the lateral malleolus: a case report and literature review. J Foot Ankle Surg, 2016, 55(2): 397-400.
19.	陈振光, 余国荣, 喻爱喜, 等. 第二跖骨头缺血性坏死的显微外科治疗. 中国修复重建外科杂志, 1998, 12(5): 283-284.
20.	俞立新, 高建明, 吴水培. 带血供第 2 跖骨底移植重建外踝的解剖学基础. 中国临床解剖学杂志, 2002, 20(6): 429-430.
21.	俞立新, 高建明, 吴水培, 等. 带血管蒂第二跖骨底骨瓣移位修复外踝骨缺损. 中国修复重建外科杂志, 2002, 16(2): 117-119.
22.	吴群峰, 俞立新, 张发惠. 创伤性外踝复合组织缺损的显微外科修复. 中国骨与关节损伤杂志, 2010, 25(10): 946-947.
23.	Gilbert A, Teot L. The free scapular flap. Plast Reconstr Surg, 1982, 69(4): 601-604.
24.	Faure P, Canovas F, Bonnel F, et al. Free osteocutaneous scapular apophysis flap for reconstruction of the lateral malleolus. Ann Plast Surg, 2001, 47(3): 328-331.
25.	杜全红, 史永安, 丛海波, 等. 游离髂骨移植重建外踝的临床研究. 中华创伤骨科杂志, 2016, 18(6): 493-497.
26.	Eger W, Schörle C, Zeiler G. Giant cell tumor of the distal fibula: fifteen-year result after en bloc resection and fibula reconstruction. Arch Orthop Trauma Surg, 2004, 124(1): 56-59.
27.	袁大为, 关鹏飞, 陈杰, 等. 带筋膜髂骨块移植修复外踝缺损的临床研究. 中国骨与关节损伤杂志, 2015, 30(4): 378-380.
28.	Rajasekaran S, Sabapathy SR. A philosophy of care of open injuries based on the Ganga hospital score. Injury, 2007, 38(2): 137-146.
29.	Ko D, Jung HG, Kim HJ, et al. Reconstruction of compound loss of lateral malleolus and lateral ankle ligaments with double-bundle Achilles tendon-bone allograft. J Foot Ankle Surg, 2014, 53(2): 189-193.
30.	Jamshidi K, Mazhar FN, Masdari Z. Reconstruction of distal fibula with osteoarticular allograft after tumor resection. Foot Ankle Surg, 2013, 19(1): 31-35.
31.	韦健, 容安, 周建飞, 等. 腓骨延长术治疗外踝开放性骨缺损. 中医正骨, 2016, 28(10): 62-63.
32.	王朝辉, 高峻青, 詹晓欢, 等. 一期清创联合二期 Ilizarov 骨搬运技术修复创伤后外踝缺损. 中国修复重建外科杂志, 2019, 33(7): 685-670.
33.	Dieckmann R, Ahrens H, Streitbürger A, et al. Reconstruction after wide resection of the entire distal fibula in malignant bone tumours. Int Orthop, 2011, 35(1): 87-92.

1. 俞立新, 马锁坤. 腓骨中段" Z”形截骨延长重建外踝一例. 中华显微外科杂志, 1997, 20(4): 250.
2. Capanna R, van Horn JR, Biagini R, et al. Reconstruction after resection of the distal fibula for bone tumor. Acta Orthop Scand, 1986, 57(4): 290-294.
3. Herring CL Jr, Hall RL, Goldner JL. Replacement of the lateral malleolus of the ankle joint with a reversed proximal fibular bone graft. Foot Ankle Int, 1997, 18(6): 317-323.
4. Babhulkar SS, Pande KC, Babhulkar S. Ankle instability after fibular resection. J Bone Joint Surg (Br), 1995, 77(2): 258-261.
5. 马武秀. 自体骨移植修复骨缺损的研究进展. 中国骨与关节损伤杂志, 2011, 26(6): 574-576.
6. 左健, 康建敏, 潘乐. 胫骨下段大段瘤性骨缺损修复重建的研究进展. 中国修复重建外科杂志, 2018, 32(9): 1211-1217.
7. 苏瑞鉴, 曾麟杰, 陈善豪. 踝关节缺损的修复重建二例. 中国修复重建外科杂志, 2006, 20(11): 1155-1156.
8. 张岩, 蔡培华, 阮洪江, 等. 吻合血管的腓骨头联合皮瓣移植修复复杂外踝缺损. 中国修复重建外科杂志, 2008, 22(11): 1288-1291.
9. Bibbo C, Ehrlich DA, Kovach SJ 3rd. Reconstruction of the pediatric lateral malleolus and physis by free microvascular transfer of the proximal fibular physis. J Foot Ankle Surg, 2015, 54(5): 994-1000.
10. 潘振宇, 喻爱喜, 张建华, 等. 带血管蒂腓骨头移植重建外踝的解剖及初步临床应用. 中华显微外科杂志, 2006, 29(5): 364-366.
11. 王树锋, 吕占辉, 王明山, 等. 带血供腓骨小头骨骺移植的解剖与临床研究. 中华骨科杂志, 2001, 21(2): 99-102.
12. Tsai TM, Ludwig L, Tonkin M. Vascularized fibular epiphyseal transfer. A clinical study. Clin Orthop Relat Res, 1986, (210): 228-234.
13. Rajacic N, Dashti H. Reconstruction of the lateral malleolus using a reverse-flow vascularized fibular head: a case report. Microsurgery, 1996, 17(3): 158-161.
14. Bickels J, Kollender Y, Pritsch T, et al. Knee stability after resection of the proximal fibula. Clin Orthop Relat Res, 2007, 454: 198-201.
15. 李静东, 宋守礼, 朱盛修. 带血管蒂的腓骨(膜)逆行移位术的解剖学基础. 解放军医学杂志, 2000, 25(4): 266.
16. 刘云建, 沈扬. 带血管蒂腓骨逆行移位重建外踝五例. 中国修复重建外科杂志, 1994, 8(4): 226-227.
17. de Gauzy JS, Kany J, Cahuzac JP. Distal fibular reconstruction with pedicled vascularized fibular head graft: a case report. J Pediatr Orthop B, 2002, 11(2): 176-180.
18. Gao YS, Zhang CQ, Sheng JG. Reverse transfer of the proximal vascularized fibula to reconstruct the lateral malleolus: a case report and literature review. J Foot Ankle Surg, 2016, 55(2): 397-400.
19. 陈振光, 余国荣, 喻爱喜, 等. 第二跖骨头缺血性坏死的显微外科治疗. 中国修复重建外科杂志, 1998, 12(5): 283-284.
20. 俞立新, 高建明, 吴水培. 带血供第 2 跖骨底移植重建外踝的解剖学基础. 中国临床解剖学杂志, 2002, 20(6): 429-430.
21. 俞立新, 高建明, 吴水培, 等. 带血管蒂第二跖骨底骨瓣移位修复外踝骨缺损. 中国修复重建外科杂志, 2002, 16(2): 117-119.
22. 吴群峰, 俞立新, 张发惠. 创伤性外踝复合组织缺损的显微外科修复. 中国骨与关节损伤杂志, 2010, 25(10): 946-947.
23. Gilbert A, Teot L. The free scapular flap. Plast Reconstr Surg, 1982, 69(4): 601-604.
24. Faure P, Canovas F, Bonnel F, et al. Free osteocutaneous scapular apophysis flap for reconstruction of the lateral malleolus. Ann Plast Surg, 2001, 47(3): 328-331.
25. 杜全红, 史永安, 丛海波, 等. 游离髂骨移植重建外踝的临床研究. 中华创伤骨科杂志, 2016, 18(6): 493-497.
26. Eger W, Schörle C, Zeiler G. Giant cell tumor of the distal fibula: fifteen-year result after en bloc resection and fibula reconstruction. Arch Orthop Trauma Surg, 2004, 124(1): 56-59.
27. 袁大为, 关鹏飞, 陈杰, 等. 带筋膜髂骨块移植修复外踝缺损的临床研究. 中国骨与关节损伤杂志, 2015, 30(4): 378-380.
28. Rajasekaran S, Sabapathy SR. A philosophy of care of open injuries based on the Ganga hospital score. Injury, 2007, 38(2): 137-146.
29. Ko D, Jung HG, Kim HJ, et al. Reconstruction of compound loss of lateral malleolus and lateral ankle ligaments with double-bundle Achilles tendon-bone allograft. J Foot Ankle Surg, 2014, 53(2): 189-193.
30. Jamshidi K, Mazhar FN, Masdari Z. Reconstruction of distal fibula with osteoarticular allograft after tumor resection. Foot Ankle Surg, 2013, 19(1): 31-35.
31. 韦健, 容安, 周建飞, 等. 腓骨延长术治疗外踝开放性骨缺损. 中医正骨, 2016, 28(10): 62-63.
32. 王朝辉, 高峻青, 詹晓欢, 等. 一期清创联合二期 Ilizarov 骨搬运技术修复创伤后外踝缺损. 中国修复重建外科杂志, 2019, 33(7): 685-670.
33. Dieckmann R, Ahrens H, Streitbürger A, et al. Reconstruction after wide resection of the entire distal fibula in malignant bone tumours. Int Orthop, 2011, 35(1): 87-92.

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