摘要
目的探讨复合骨移植在下肢骨肿瘤保肢术中重建骨缺损的手术原理及效果. 方法应用携带监测皮岛吻合血管的自体腓骨与深低温冷冻大段同种异体骨复合移植,重建下肢骨肿瘤切除后的长段骨缺损12例.其中,骨肉瘤6例,恶性纤维组织细胞瘤1例,骨纤维结构不良2例,骨巨细胞瘤3例. 结果 12例经术后8～38个月随访,1例死于肺转移,2例带瘤存活,9例无瘤存活.术后功能优良率达75%.10例术后3个月内X线示骨端骨性愈合,2例内固定失败重新外固定后骨性愈合,所有均在9个月内能完全负重行走. 结论携带监测皮岛吻合血管的自体腓骨与深低温冷冻大段同种异体骨复合移植,适用于下肢骨肿瘤保肢术中的长段骨缺损的修复,具有自体活骨移植和异体骨移植的双重优点.
Objective To explore the clinical effects of the limb sparing surgery using a free vascularized fibular transfer with a monitoring - flap combining with massive bone allograft reconstruction of lower extremity bone defects after bone tumor resection. Methods From January 2001 to June 2003, the authors treated 12 consecutive patients who had massive bone defect after primary bone tumor resection in lower extremity using and the composite bone graft. There were five males and seven females, and the mean age at surgery was 23.3 years old （range ,6- 49 years old）. Pathologic diagnoses included six osteosacoma, one malignant fibrous histiocytoma, three malignant gaint cell tumor of bone, and two fibrous dysplasia. Primary spot：9 cases of remus,3 cases of tibia. Results All of 12 patients were followuped. The mean follow - up time was 22.1 months （range,8-38）. Two patients were died of lung metastases,and one alive with tumor,and 8 survivals without tumor. According to Mankin＇s bone graft criterion, the good - excellent rate of function outcome was 75%. Ten patients had the evidence of radiographic union three months after surgery. The mean union time was 3.4 months. The mean postoperative full weight - bearing time of the reconstructed limb was 6.2 months （range,5- 9 months）. Conclusion The combined bone graft possesses the advantages both free vascularized fibular transfer with a monitoring - flap and massive bone allograft. Based on the results of the current study, the combined bone graft is a reliable technique for lower extremity reconstruction following primary tumor resection and associate with sati factional function outcome.
出处
《中华显微外科杂志》
CSCD
北大核心
2005年第4期309-311,i0003,共4页
Chinese Journal of Microsurgery
基金
广东省科技厅资助项目(2002-254-20)
作者简介
通讯作者：徐中和
