THE USE OF BLOOD-SUPPLIED BONE AUTOGRAFTS IN THE SURGICAL TREATMENT OF CHILDREN WITH PSEUDOARTHROSES AND CLAVICLE DEFECTS
Pseudoarthroses and clavicle defects are very rare pathology in children. Congenital pseudoarthrosis is classified as a separate nosological unit and, according to the literature, most authors prefer to use various types of osteosynthesis in combination (or without it) with bone grafting of free bone fragments from the iliac crest, rib, or fibula. In cases of acquired pseudoarthrosis or clavicle defects in children, traditional methods of treatment are also mainly used. Although in several articles we came across a description of the treatment of this pathology using vascularized fibula or ribs autotransplantation. In our clinic, to restore of the clavicle, 8 microsurgical transplants of blood-supplied bone fragments in children were performed. For transplantation, we used the lateral edge of scapula in 4 cases, the diaphysis of fibula in 3 cases, and the rib with thoraco-dorsal flap in 1 case. Thanks to the blood supply, all autografts survived and the terms of fusion with fragments of the clavicle did not exceed 2-2.5 months. We consider the use of a blood-supplied fragment of the scapule lateral edge to be more preferable for plastic surgery of clavicle, because it can be moved in a non-free version to the recipient zone. However, the use of autotransplantation of blood-supplying fragments of other bones can also be used depending on the condition of recipient zone and the length of the clavicle defect. The results of this method of treatment testify to its relevance and high efficiency.