皮质外骨桥固定特制假体置换治疗肢体骨肿瘤

目的]确定采用特制假体及特殊植骨方法固定后，假体与骨交界区能否有效形成皮质外骨桥，皮质外骨桥能否起到有效的辅助固定作用，皮质外骨桥的形成和重建有何规律。方法]44例患者行皮质外骨桥加强固定，带有1～4am多孔表面区的特制假体置换。31例患者资料可供分析，以了解植入后固定的效果以及骨桥形成和重建的规律。结果]31例患者中有25例（81％）形成了有效的骨桥固定，骨桥在股骨后侧和内侧的压应力区形成更为丰富。结论]在假体与骨端交接区的珍珠面和骨皮质之间良好植骨可有效构建骨桥；骨桥的重建与应力和血运有关；髓内固定、珍珠面、皮质外植骨有利于形成有效的骨桥固定。

Extra-cortical bone bridge fixation for tumor prostheses

Objective] To confirm whether an effective extra-cortical bone bridge could be formed in the conjunction between stem shoulder and the bone ends with a combined bone grafting. Method] A total of 44 eases were operated with this technique, 31 prostheses were evaluated for the ability of formation and remodeling of the bone bridge. Result] Effective extra-cortical bone bridge was formed in 25 out of the 31 cases, with the medial and the posterior side being more abundant. Conclusion ] The bone bridge could be effectively formed by good grafting technique. The forming and reconstruction result was affected by stress and blood supply. Primary stability of cementation, porous surface in the shoulder area and good bone grafting technique are the key facts to bone bridge formation.