摘要
目的 探讨大段异体骨移植在骨肿瘤保肢治疗中的临床疗效。方法 回顾观察了 1991年 9月～ 1998年 10月，应用大段异体骨修复 79例骨肿瘤患者瘤段骨切除后骨缺损的治疗情况。男 55例，女 24例；年龄 9～ 70岁，平均 28.8岁。骨肉瘤 38例，恶性骨巨细胞瘤 12例，其他肿瘤 29例。骨段移植 24例，半关节移植 50例，复合人工关节移植 5例。植入异体骨长度 8～ 22 cm，平均 13.5 cm。非交锁型髓内钉固定 16例，交锁型髓内钉固定 53例，钢板固定 5例，复合人工关节移植 5例。结果 67例患者得到随访，时间 5个月～ 7年，平均 2.8年，结果异体骨愈合 62例，不愈合 5例。主要并发症 :复发 8例，感染 8例，骨不连 5例，骨折 4例，内固定失败 4例，关节面吸收塌陷 7例。功能按 Mankin标准评定 :优 25例，良 23例，中 11例，差 8例。结论 大段异体骨移植是一种修复骨肿瘤瘤段切除后骨缺损的有效手段；牢固的髓内固定有利于异体骨愈合。
Objective To report the results of large segment allografts in the treatment for bone tumor. Methods A retrospective analysis of 79 consecutive cases of large segment allograft implantations after resection of bone tumors from september 1991 to october 1998 was conducted. The allogeneic bone healing were observed. Fifty five of the 79 cases had an average age of 28.8 years (ranged 9－ 70 years). There were 38 osteosarcomas, 12 aggressive giant cell tumor of bone, 29 other bone tumors. Inter segmental allograft was performed in 24 cases, osteoarticular allograft 50 cases, allograft and prosthesis 5 cases. The mean length of allograft was 13.5 cm (ranged 8－ 22 cm). The types of fixation included common intramedullary nailing in 16 cases, interlocking intramedullary nailing in 53 cases, plate in 5 cases, prosthesis 5 cases. Results Followed up period ranged from 5 months to 7 years (average, 2.8 years) in 67 cases. 62 cases had union and 5 non unions. There was significant difference between the rate of union after fixation with common intramedullary and that after interlocking intramedullary fixation (P<0.05).The major complications were reccurrence in 8 cases, nonunion 5 cases had excellent results,23 cases good, 11 cases fair and 8 cases poor. Conclusion The allograft bones implantation is a most desirable graft material for repair of bone defected in course of limb salvage following resection of bone tumors. Satisfactory union were obtained with a stable interlocking intramedullary nail fixation.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第7期406-409,共4页
Chinese Journal of Orthopaedics
关键词
骨肿瘤
冷冻保存
同种异体骨移植
Bone neoplasms
Transplantation, homologous
Bone transplantation
Freezing
Tissue preservation
Treatment outcome
