瘤段骨切除灭活再植治疗骨关节恶性肿瘤(附16例报告)

目的 分析瘤段骨切除、去除瘤组织、灭活处理后，原位再植重建骨缺损治疗骨肿瘤的疗效。方法1998年10月-2003年4月，对16例长骨恶性肿瘤患施行广泛切除，瘤段骨离体灭活，95％酒精浸泡45分钟灭活，彻底清除瘤组织，回植原位，修复关节韧带，髓内钉内固定，手术前后辅助化疗。结果 全部病例平均随访28个月，2例因肺转移死亡，1例感染、1例髓内钉折断，随后局部复发截肢，灭活骨骨折、塌陷各1例，并发症发生率37．5％，保肢率75％。结论 瘤段骨切除灭活再植，手术简便，花费低廉，无排斥反应，骨连接处可达生物愈合，是治疗骨肿瘤保肢的有效方法。

Bone defect reconstruction with devitalized bone stump after resection of malignant bone tumor (16 Cases Report)

Objective To study a method for reconstruction of bone defects after resection of bone tumor withbone shell which the tumor tissues were wiped out by alcoholic devitalization. Method From October 1998 to April2003, 16 cases of long bone tumor were treated by resecting bone tumor region, removing of tumor, immerging the bonestump into a big beaker that contained 95 % alcohol for 40 - 45 minutes. Subsequently, the defect was reconstructed withdevitalized bone shell in situ, repairing joint ligament, fixing with intramedullary fixation. All patients underwent adjunc-tive chemotherapy. Results All patients were followed - up for an average of 28 months. Two cases died of pulmonarymetastasis, 2 cases underwent amputation because of local recurrence, 1 case occurred fracture of devitalized bonestump, 1 case underwent subsidence of devitalized bone stump. The rate complication was 37. 5%, the rate of limb sal-vage was 75%. Conclusions Reconstruction the defects with devitalized bone stump is an effective method for limb sal-vage of bone tumor. It is simple, low cost and no reject reaction.