带血运骨移植修复四肢骨肿瘤切除骨缺损

目的观察带血管蒂骨瓣移植修复四肢骨肿瘤切除后骨缺损,重建肢体功能的价值。方法对31例四肢骨肿瘤进行彻底切除后,26例采用带血管蒂骨瓣移植修复骨缺损,5例采用带血管蒂腓骨小头移植重建关节。其中3例恶性肿瘤同时采用新辅助化疗进行治疗。观察内容包括植骨愈合情况、Enneking肢体功能评价和肿瘤复发情况。结果随访1⁵年6个月,平均38个月。28例移植骨愈合良好;Enneking肢体功能评价总体优良率85.7%;其中27例治愈,1例骨化性纤维瘤复发,经再次相同手术方式治疗后未再复发,1例骨肉瘤复发和1例骨巨细胞瘤恶变,二次手术行肿瘤型人工关节置换,1例骨肉瘤患者随访期内死亡。结论带血管蒂骨移植修复四肢骨肿瘤切除后骨缺损疗效满意,可以满足四肢骨的功能重建要求。

Vascularized Bone Graft Transplanting for Treatment of Limb Bone Tumors

Objective To observe the value of vascularized bone graft transplanting for the defects of limb bone tumors resected. Methods 26 cases underwent vascularized bone graft transplanting for repair bone defects and 5 cases underwent vascularized capitulum fibulae for reconstruction of bone joint after the limb bone tumors were resected thoroughly. 3 cases of malignant tumor underwent the operations combine with the new aid chemo. The observe items including bone union, Enneking evaluate system and recurrence of the bone tumors. Results The average follow-up time was 38 months. Bone unions were well for 28 cases. Total excellent and good rate was 85.7%according to Enneking evaluate system. 27 cases were cured. 1case of ossifying fibromm were cured after underwent the same surgical treatment while relapsed,2 cases were underwent prosthetic replacement because of 1 case of osteosarcoma and the other case of giant cell tumor of bone was relapsed. 1 case was died in the follow-up. Conclusion The effect of vascularized bone graft transplanting for the defects of limb bone tumors resected is satisfied, which can meet the requirement of functional reconstruction of limb bones.