摘要
目的探讨骨肿瘤保肢中应用大段异体皮质骨联合吻合血管自体腓骨结构性修复下肢骨肿瘤切除后大段骨缺损的临床效果。方法2001年1月～2005年12月,对17例患者下肢骨肿瘤切除后骨缺损采用大段异体皮质骨联合吻合血管自体腓骨进行结构性修复。其中男10例,女7例。年龄6～34岁。骨缺损部位:股骨8例,胫骨9例。骨缺损范围12～25cm,平均16.6cm。采用自体腓骨15～28cm,平均18.3cm;异体骨11～24cm,平均16.1cm。自体腓骨干14例,腓骨近段3例,均携带监测皮岛;捆绑式复合移植3例,嵌套式14例。结果所有患者随访6～48个月,平均20.2个月,供、受区创口均I期愈合,监测皮岛成活并与周围组织正常愈合,无明显排斥反应,无供区肢体功能障碍。Mankin评分:优8例,良5例,可2例,差2例,优良率76.47%。结论大段异体皮质骨联合吻合血管自体腓骨结构性修复下肢骨肿瘤切除后大段骨缺损效果满意。
Objective To report the clinical outcomes of bone architecture repair of bone defects secondary to bone tumors resection in lower extremities by using massive cortical bone allografts with combining vascularized fibular autografts. Methods 17 patients with bone defects （10 male and 7 female, age ranged from 6 to 34 years） were reconstructed by massive cortical bone allografts with combining vascularized fibular autografts. Length of bone defects were from 12 to 25 cm （mean： 16.6 cm） and the length of vascularized free fibular were 15 to 28 cm （mean： 18.3 cm） and length of massive bone allografts were 11 to 24 cm （mean： 16.1 cm）. Locations of the disease were eight in femur and nine in tibia. Results After 6 to 48 months （mean： 20.2 months） follow-up, all wounds of donor and recipient sites were healed, monitoring-flaps were survive, eject reaction were slight, no complications in donor limbs. 13 patients had the evidence of radiographic union at 6 months after surgery, three cases united 8 months, and the remained one case of synovial sarcoma recurred and the leg was amputated 2.5 months postoperatively. Five patients had been removed internal fixation and complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow up. There were 8 excellent, 5 good, 2 fair and 2 poor due to Mankin rating system. Total excellent and good rate is 76.47%. Conclusions It is a satisfactory bone architecture repair method of massive bone defects secondary to bone tumors resection in lower limbs by using massive cortical bone allografts with combining vascularized fibular autografts.
出处
《中国骨肿瘤骨病》
2006年第6期333-336,共4页
Chinse Journal Of Bone Tumor And Bone Disease
关键词
骨肿瘤
骨缺损
骨移植物
修复
下肢
Bone tumors
Bone defects
Bone grafts
Repair
Lower extremities
