骨肿瘤术后骨缺损的显微外科修复（附49例报道）

临床上四肢长管骨肿瘤手术,既要彻底地切除病灶,又要尽力保全肢体和关节以达到满意疗效,难度较大。本文介绍我科采用显微外科技术,作骨肿瘤局部大块或大段切除、吻合血管的游离骨移 植修复肿瘤切除后的骨缺损,或肿瘤段截再植术共49例。术后随访3～6个月植骨区全部达到骨性愈合,肢体功能得以保全或改善,达到了满意的疗效。

MICROSURGICAL REPAIRMENT OF MASSIVE BONE DEFECTS IN THE EXTREMITIES AFTER RESECTION OF BONE TUMOR

In this paper we present our clinical experience with the use of microvascular free bone trans- fer from 1979 to 1991 in 49 massive bone defects resulting from bone tumor resection of long bone end in the upper and lower extremities. The treatment consisted of three kinds of microsurgical operation:replantation after segmental amputation of bone tumor limbs(5 cases),joint reconstruction with free head-shaft of fibular(10 cases),and microvascular free transfer of iliac bone on the deep superior branches of the superior gluteal vessels and deep circumflex iliac vessels (34 cases). All the outcomes turned out to be successful. Among the 49 cases were lower femur and upper tibial 23 cases (47%);upper femur 4 cases(8. 2%);upper humerus 8 cases (16. 3%);distal end of the radius and ulnas 12 cases (24. 5%); lower jaw 2 cases (4%). The results were satisfactory at follow-up .This review also deal with clinical assessment,merit and operative indication.