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吻合血管的腓骨多术式移植重建肿瘤性骨关节缺损
Hits: 2153   Download times: 1503   Received:December 02, 2009    
作者Author单位UnitE-Mail
冯峰 FENG Feng 洛阳正骨医院骨肿瘤科,河南 洛阳 471002 Department of Bone Tumor,the Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China  
李东升 LI Dong-sheng 洛阳正骨医院骨肿瘤科,河南 洛阳 471002 Department of Bone Tumor,the Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China  
张志勇 ZHANG Zhi-yong 洛阳正骨医院骨肿瘤科,河南 洛阳 471002 Department of Bone Tumor,the Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China  
黄满玉 HUANG Man-yu 洛阳正骨医院骨肿瘤科,河南 洛阳 471002 Department of Bone Tumor,the Luoyang Orthopaedics Hospital,Luoyang 471002,Henan,China  
期刊信息:《中国骨伤》2010年23卷,第3期,第197-199页
DOI:10.3969/j.issn.1003-0034.2010.03.015


目的:探讨吻合血管的腓骨多术式移植重建肿瘤性骨关节缺损的方法及疗效。

方法:1996年10月至2005年1月应用多种吻合血管的腓骨移植术式治疗89例肿瘤性骨关节缺损,男48例,女41例;年龄12~67岁,平均35岁。其中病灶清除腔内嵌入植骨术35 例;瘤段切除单节段或双节段腓骨植骨术15例;近关节肿瘤切除带腓骨头半关节移植术16例;病灶外科边缘切除双段腓骨、髂骨联合植骨术23例。

结果:根据Enneking肢体功能评价标准,对术后功能评价:病灶清除腔内嵌入植骨术35 例中29例获随访,优26例,良1例,可2例;瘤段切除单节段或双节段腓骨植骨术15例中12例获随访,优8例,良1例,可1例,差2例;近关节肿瘤关节切除带腓骨头半关节移植术16例中12例随访, 优7例,良3例,可1例,差1例;病灶外科边缘切除双段腓骨髂骨联合支撑植骨术23例中17例获随访,优11例,良3例,可1例,差2例。

结论:吻合血管的腓骨多术式移植重建骨关节缺损,极大地丰富了骨肿瘤的治疗方法,可以满足四肢多部位肿瘤切除后的功能重建,效果可靠。手术操作时,需要根据不同病变选择相应术式。
[关键词]:骨肿瘤  外科手术  移植  腓骨
 
Reconstruction of tumor-induced bone defects with vascularized fibula graft
Abstract:

Objective: To study the Methods and effects of the reconstruction of tumor-induced bone defects with vascularized fibula graft.

Methods: From Oct.1996 to Jan.2005,89 patients with bone defects were treated with fibula graft using different Methods. Among the patients,48 patients were male and 41 patients were female,ranging in age from 12 to 67 years,with an average of 35 years. Thirty-five patients were treated with inlay bone grafting after excision of focus,15 patients were treated with single or double-strut fibula graft after tumor resection,16 patients were treated with fibular head graft for juxta articular tumor resection,and 23 patients were treated with double-strut fibula combined with iliac graft after marginally resection.

Results: Enneking evaluation system was used to evaluate therapeutic effects. Among 35 patients treated with inlay bone graft after excision,29 patients were followed up,and 26 patients got an excellent result,1 good and 2 poor. Among 15 patients treated with single or double-strut fibula graft after tumor resection,12 patients were followed up,and 8 patients got an excellent result,1 good,1 poor and 2 bad. Among 16 patients treated with fibular head graft for juxta articular tumor resection,12 patients were followed up,and 7 patients got an excellent result,3 good,1 poor and 1 bad. Among 23 patients treated with double-strut fibula combined with iliac graft after marginally resection,17 patients were followed up,and 11 got an excellent result,3 good,1 fair and 2 bad.

Conclusion: These treatment Methods can greatly enrich the treatment Methods for bone tumor,and satisfy the reconstruction after bone tumor excision in different position of the four limbs. These Methods are reliable and can be chosen according to disease types.
KEYWORDS:Bone neoplasms  Surgical procedures,operative  Transplantation  Fibula
 
引用本文,请按以下格式著录参考文献:
中文格式:冯峰,李东升,张志勇,黄满玉.吻合血管的腓骨多术式移植重建肿瘤性骨关节缺损[J].中国骨伤,2010,23(3):197~199
英文格式:FENG Feng,LI Dong-sheng,ZHANG Zhi-yong,HUANG Man-yu.Reconstruction of tumor-induced bone defects with vascularized fibula graft[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(3):197~199
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