目的 探讨桡骨远端骨肿瘤切除后,腕关节功能重建方法及其远期疗效。方法 回顾性分析桡骨远端骨肿瘤64例(骨巨细胞瘤51例,软骨肉瘤7例,恶性纤维组织细胞瘤6例),均行瘤段广泛切除。采用不同方式重建桡腕关节,其中带血管蒂腓骨上段移植27例,游离腓骨上段移植23例,人工腕关节置换8例,同种异体桡骨下端移植6例。对64例患者的疼痛情况、功能、腕关节活动度、X线片及肿瘤复发情况等指标进行比较研究,平均随访10年3个月。结果 51例骨巨细胞瘤有3例2-3年后局部软组织复发,再次行手术切除软组织肿块;7例软骨肉瘤有4例无瘤存活,2例局部复发行截肢术,1例死于肺转移;6例恶性纤维组织细胞瘤有2例无瘤存活(分别为术后8年和19年),4例术后1-5年肺转移死亡。4种重建方式中,腓骨上段移植组功能优良率达93％以上(带血管蒂腓骨上段移植组骨愈合较快,平均3.2个月;游离腓骨上段移植组移植骨平均愈合时间为4.9个月,但两组间远期腕关节功能恢复及优良率差异无显著性;人工腕关节组腕关节各项活动均较好,但手的握力不如腓骨上段移植组,优良率为87.3％;同种异体桡骨下端移植组功能恢复较差。结论 桡骨远端破坏较广的侵袭性骨肿瘤及其他恶性骨肿瘤,行瘤段广泛切除后,可根据肿瘤性质及骨缺损情况,选用不同方法重建腕关节功能。对于恶性 Objective To explore the method of functional reconstruction of the wrist and its long-term curative effect after resection of the distal radius tumor. Methods A retrospective analysis of 64 cases of distal radius tumors (51 cases of giant cell tumor of bone, 7 cases of chondrosarcoma and 6 cases of malignant fibrous histiocytoma) were performed extensive excision. The radial wrist was reconstructed in different ways. Among them, 27 cases were transplanted with the upper fibular pedicle of vascularis, 23 cases were transplanted in the upper fibula, 8 cases were replaced by artificial wrist, and 6 cases were transplanted in the lower radius of allograft. 64 patients with pain, function, wrist mobility, X-ray and tumor recurrence and other indicators were compared with an average of 10 years and 3 months follow-up. Results Three cases of giant cell tumor of bone in 51 cases had local soft tissue recurrence after 2-3 years and resected soft tissue mass again. Four cases of chondrosarcoma survived without tumor, two cases of local recurrence amputation and one died of lung There were 2 cases of malignant fibrous histiocytoma survived without tumor (8 years and 19 years after operation, respectively), and 4 cases died of pulmonary metastasis 1 to 5 years after operation. Among the four reconstruction methods, the excellent and good rate of the superior fibular graft was over 93% (the bone union of the upper fibular graft with vascular pedicle was faster, with an average of 3.2 months. The mean graft healing time of the free fibular upper graft was 4.9 months, However, there was no significant difference between the two groups in long-term wrist function recovery and excellent and good rate. The activities of wrist joint in artificial wrist group were better, but the hand grip strength was lower than that in the upper fibular graft group, the excellent and good rate was 87.3% Radial lower end of the graft group functional recovery is poor.Conclusion Wound distal to the destruction of a wide range of aggressive bone tumors and other malignant bone tumors, extensive excision of the tumor segment, according to the nature of the tumor and bone defects, choose different methods to reconstruct the function of the wrist For malignant