保留骨骺保肢手术治疗儿童及青少年肢体骨肉瘤的基本原则与临床疗效

保留骨骺保肢术是治疗儿童及青少年肢体骨肉瘤的一种方法,其目的是在不增加危及生命并发症发生的前提下避免术后双侧肢体不等长及改善术后的肢体功能。严格遵循手术适应症是保证手术成功的关键。术前骨骺牵张或借助影像学的方法确定术中截骨部位已达到肿瘤切除的安全边界,可采取多种方式修复肿瘤性骨缺损。临床研究证实各种手术方法均取得了一定的临床疗效,但也存在不同的手术并发症.只有将骺板与骨骺同时保留时才能保证肢体长度的等长;骨骺内截骨的结果是骨生长的阻滞导致肢体的不等长。实施骨缺损的生物学重建可在骨生长停止后应用骨延长的方法恢复肢体的长度。

The basic principle and clinical outcomes of epiphysis preservation limb salvage in the treatment of limb osteosarcoma in children and adolescents

Epiphyseal preservation limb salvage is a method for the treatment of limb osteosarcoma in children and adolescents.The purpose is to avoid the unequal length of bilateral limbs and improve the affected limb function without increasing the occurrence of life-threatening complications.Strictly following the indications is the key to ensure the success of the operation.Before operation,epiphyseal distraction or imaging method is used to determine the position of osteotomy in operation,which has reached the safe boundary of tumor resection.Many ways were used to repair the tumor bone defect.A lot of studies confirmed that all kinds of surgical methods have achieved satisfied clinical outcomes,but there are different surgical complications.Only when the epiphyseal plate and epiphysis are kept at the same time can the length of the limb be ensured to be equal;the result of intra-epiphyseal osteotomy is that the block of bone growth leads to the unequal length of the limb.The biological reconstruction of bone defect can restore the length of limbs by bone lengthening after bone growth stops.