自体腓骨移植治疗桡骨远端骨巨细胞瘤

目的：探讨白体近端腓骨移植重建在桡骨远端骨巨细胞瘤临床治疗中的应用及效果。方法：对4例桡骨远端骨巨细胞瘤复发（Campanacci Ⅲ级）患者在行桡骨远端瘤段切除的同时,行自体近端腓骨移植重建手术。结果：所有患者随访27～50个月,疼痛症状消失,骨愈合时间5～9个月,平均愈合时间为6．5个月,无移植骨吸收和骨折,腕关节功能握持力为对侧手的55％（40～80％）,背伸活动度可达对侧50％（10～80％）,掌屈达40％（15～70％）,无神经血管损伤症状,恢复正常工作劳动。所有患者均未出现骨巨细胞瘤的复发及肺转移。结论：桡骨远端骨巨细胞瘤经广泛切除后,用自体近端腓骨移植进行保肢治疗,可较好地保留腕关节功能,是一种有效的治疗方法。

Autoallergic Fibular Transplantation for Treatment of Radial Giant Cell Tumour

Objective： To discuss the clinical application and effect of autogenous fibular graft for bone reconstruction after resection of giant cell tumor （GCT） in the distal radius. Methods： Autogenous fibular graft for bone reconstruction was applied to 4 patients who underwent resection of the GCT in distal radius. Results： All of the patients were followed up for 27-50 months. Bone graft healing occurred at a mean time of 6.5 months （range, 5-9 months） and there were no pain, grafting bone resorption or fracture noted. The grip strength of the involved side was about 55% （range, 40-80%）. The average ranges of motion of the wrist were about 50% of dorsiflexion （range, 10-80%） and 40% of palmar flexion （range, 15-70%）. All patients were able to perform activities of daily living without local recurrence or pulmonary metastasis. Conclusion： Wide resection with reconstruction of the wrist using a non-vascularized fibular autograft is an ideal method for treatment of giant cell tumor （GCT） in the distal radius.