四肢恶性骨肿瘤切除后骨缺损使用异体骨移植术重建修复的疗效

目的:研究同种异体骨移植术修复重建四肢恶性骨肿瘤切除后骨缺损的临床疗效。方法:选取2016年03月至2019年08月我院收治的四肢恶性骨肿瘤切除后骨缺损行同种异体骨移植重建修复的患者15例和行复合肿瘤型人工关节置换的患者9例；本文研究对象均经穿刺活检和术后病理确诊；Enneking分期Ⅰb期6例，Ⅱb期18例；术前尤文肉瘤3例和骨肉瘤15例患者均行2个疗程化疗和术后规范化疗；应用MSTS评价术后患者的肢体功能情况。结果:所有患者均获得随访，随访时间为8~46个月，平均（29.63±11.21）个月；24例患者术后均未发生假体周围骨折或移植异体骨折，且无假体松动和关节脱位；20例患者术后肢体功能优良，MSTS评分为16~28分，平均（22.80±4.46）分。结论:四肢恶性骨肿瘤切除术后骨缺损使用异体骨段移植重建长骨干缺损和或肿瘤型人工关节复合置换治疗的临床疗效显著。

The curative effect of reconstructing and repairing bone defect with allogeneic bone graft after resection of malignant bone tumor of extremities

Objective:To study the clinical effect of allogeneic bone graft in repairing and reconstructing bone defect after resection of malignant bone tumor in extremities.Methods:Fifteen patients underwent allogeneic bone graft reconstruction and nine patients underwent combined tumor-type artificial joint replacement were collected from March 2016 to August 2019 in our hospital with bone defect after resection of malignant bone tumor of extremities.All subjects in this article were confirmed by needle biopsy and postoperative pathology.There were 6 cases of stageⅠ_b and 18 cases of stageⅡ_b in Enneking stage.3 cases of Ewing's sarcoma and 15 cases of osteosarcoma were treated with 2 courses of chemotherapy and standard chemotherapy after operation.MSTS was used to evaluate the limb function of patients after operation.Results:All patients were followed up.The follow-up time was 8~46 months,with an average of(29.63±11.21)months.There were no fractures around the prosthesis or allograft fracture in 24 patients,and no prosthesis loosening or joint dislocation.Twenty patients had excellent postoperative limb function.The MSTS score was 16~28 points,with an average of(22.80±4.46)points.Conclusion:After the resection of malignant bone tumor of the extremities,the use of allogeneic bone graft to reconstruct the long bone defect and/or tumor-type artificial joint composite replacement for bone defect has significant clinical effects.