| 骨巨细胞瘤术后复发的手术治疗 |
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Received:August 09, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李东升 |
LI Dong-sheng |
洛阳正骨医院骨肿瘤科, 河南洛阳471002,在读研究生 |
The Department of Bone Tumor,Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
Luoyanglds@163.com |
| 冯峰 |
FENG Feng |
洛阳正骨医院骨肿瘤科, 河南洛阳471002,在读研究生 |
The Department of Bone Tumor,Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
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| 古建立 |
GU Jian-li |
洛阳正骨医院骨肿瘤科, 河南洛阳471002,在读研究生 |
The Department of Bone Tumor,Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
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| 张志勇 |
ZHANG Zhi-yong |
洛阳正骨医院骨肿瘤科, 河南洛阳471002,在读研究生 |
The Department of Bone Tumor,Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China |
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| 郭建刚 |
GUO Jian-gang |
上海中医药大学 |
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| 黄满玉 |
HUANG Man-yu |
上海中医药大学 |
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| 期刊信息：《中国骨伤》2006年19卷，第9期，第543-545页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:探讨骨巨细胞瘤术后复发的手术方法及疗效。
方法:1994年6月-2003年10月,收治四肢长骨复发性骨巨细胞瘤18例,男12例,女6例;年龄18~44岁,平均26岁。股骨下端5例,胫骨上端8例,股骨上端1例,桡骨远端4例。Enneking分期:Ⅰa期14例,Ⅰb期4例。放射影像学Cam-panicci分级:Ⅰ级7例,Ⅱ级7例,Ⅲ级4例。病理学Jaffe分级:Ⅰ级8例,Ⅱ级7例,Ⅲ级3例。采用肿瘤扩大切除,吻合血管的自体腓骨、髂骨联合移植术治疗9例;瘤段切除,吻合血管的腓骨头移植重建术4例;瘤段切除,人工假体置换术5例。
结果:随访时间11~110个月,平均66个月。所有移植骨术后均愈合,一侧关节间隙轻度狭窄2例,术后再复发1例。术后功能评价:优13例,良3例,可1例,差1例。
结论:肿瘤扩大切除,吻合血管的自体腓骨、髂骨联合移植术既能彻底切除病变,又能保持和重建关节功能,是一种较理想的方法,Campanicci分级Ⅲ级、病理学Jaffe分级Ⅱ~Ⅲ级的复发性骨巨细胞瘤原则上应施行更为广泛的瘤段切除术,桡骨远端复发性骨巨细胞瘤因其部位的特殊性,应用自体腓骨移植重建效果良好。 |
| [关键词]:巨细胞瘤,骨 骨移植 外科手术 肿瘤复发,局部 |
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| Surgical treatment for the postoperative recurrence of giant cell tumor of bone |
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Abstract:
Objective:To explore the surgical treatment for the postoperative recurrence of giant cell tumor of bone and to study its therapeutic effects.
Methods:From 1994.6 to 2003.10,18 patients with recurrence of giant cell tumor of bone in long bones of limbs were treated with operative methods.Among them, 12 patients were male and 6 patients were female,ranging in age from 18 to 44 years(mean 26 years).Five patients had the tumor in the distal end of femur,8 patients had the tumor in the proximal end of tibia,1 patient had the tumor in the proximal end of femur,and 4 patients had the tumor in the distal end of radius.The patients were classified according to Enneking’s staging standard:14 patients were Ⅰa stage and 4 patients were Ⅰb stage.According to Campanicci radiological classification,7 patients were Ⅰ degree,7 patients Ⅱ degree and 4 patients Ⅲ degree.The tumors were classified based on Jaffe pathological standard:Ⅰdegree occurred in 8 patients,Ⅱ degree in 7 patients and Ⅲ degree in 3 patients.In 9 patients the tumors were cut in a large area,and self-fibula and iliac combined with blood vessels were grafted,in other 4 patients the tumors were cut and the self-caput fibulae accompanied with blood vessel were grafted and reconstruted,and in the rest 5 patients were treated with tumor-cutting and prosthesis replacement.
Results:All the patients were followed up from 11 to 110 months,with an average of 66 months.All grafting bones healed well after operation.Single side joint space was slightly narrowed in 2 patients,and postoperative recurrence was found in 1 patient.The postoperative functional evaluation showed that 13 patients obtained excellent results,3 good,1 fair and 1 bad.
Conclusion:Tumor cutting in large area combined with self-fibula and iliac grafting accompanied with blood vessel is an ideal method for the treatment of postoperative recurrence of giant cell tumor of bone,which is effective to resect tumor completely without lost of articular function.For recurrent giant cell tumor of bone at Ⅲ degree of Campanicci classification and Ⅱ to Ⅲ degree of Jaffe classification,widely cutting of tumor should be performed.For recurrent giant cell tumor of bone in the distal end of radius,self-fibula grafting transplantation and reconstruction is an effective method because of the tumor’s occurring in special area. |
| KEYWORDS:Giant cell tumor of bone Bone grafting Surgical procedures,operative Neoplasm recurrence,local |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李东升,冯峰,古建立,张志勇,郭建刚,黄满玉.骨巨细胞瘤术后复发的手术治疗[J].中国骨伤,2006,19(9):543~545 |
| 英文格式: | LI Dong-sheng,FENG Feng,GU Jian-li,ZHANG Zhi-yong,GUO Jian-gang,HUANG Man-yu.Surgical treatment for the postoperative recurrence of giant cell tumor of bone[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(9):543~545 |
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