异体骨关节移植修复肢体大段骨缺损的术后并发症

目的 分析肢体恶性肿瘤患者接受异体骨关节移植修复重建大段骨缺损的术后并发症并探讨其处理方法。方法 因肢体恶性骨肿瘤行瘤段切除,采用不同内固定方式进行异体骨－关节移植术并有完整随访资料的患者１０６例,随访时间１０～１１２个月,平均３２．３个月。术后最终结果按Ｍａｎｋｉｎ’ｓ标准评价。结果 与深低温冷冻异体骨相比,酒精浸泡异体骨移植更易发生感染、骨不连等并发症;异体骨段移植或复合人工关节移植优于半关节

Complications of massive allografts after segmental resection of malignant bone tumors

OBJECTIVE: To analyze the postoperative complications of bone and joint allografting for the reconstruction of massive bone defect after the resection of malignant bone tumors and its management. METHODS: Bone-joint allografting for the reconstruction of massive bone defect after the resection of malignant bone tumors with different internal fixations was performed in 106 patients with complete follow-up data. Bone healing time, complication rate, and final results in different allografts were compared. Operation indications, complications and internal fixation were also analyzed. The final results were determined according to the Mankin's standard. RESULTS: Allografts Alcohol immersed were more susceptible to infection, non-union, etc. Allografts and combined prosthesis were superior to semi-articular transplantation. Complications included deep infection (10%), skin necrosis (12.2%), local recurrence (14.4%), and delayed union or non-union (15.6%). Dynamic interlocked intramedullary nailing was superior to conventional intramedullar nailing and compression plates. CONCLUSIONS: Allografting is acceptable for the reconstruction of massive bone defect after tumor resection. Its results are encouraging after proper management of complications caused by surgical technique, internal fixation and soft tissue repair.