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目的 探讨骨肿瘤切除后大块骨缺损的修复重建方法。 方法 1998年 5月～ 2 0 0 2年 5月 ,根据肢体骨肿瘤切除后造成骨缺损的部位及大小形状 ,选择深低温冷冻同种异体骨制备成与之大体匹配的骨半关节、骨干段或骨条、骨粒修复骨缺损 ,辅以交锁髓内钉或加压钢板螺钉行坚强内固定。 结果 本组 2 2例 ,术后随访 3～ 4 2个月 ,无瘤存活 2 0例 ,死亡 2例。其中 1例行半膝关节移植者出现排异反应 ,伤口不愈合 ,经皮瓣修复仍不愈合而截肢 ;其余 2 1例患者摄 X线片和 /或 99m Tc SPECT检查提示均有不等量骨痂生成和 /或核素浓集 ,提示有骨愈合。患肢术后功能恢复以Markin骨移植结果评定标准评定 ,优良率达 81.8%。 结论 应用同种异体骨、关节移植修复骨肿瘤切除后骨缺损是一种理想有效的修复方法 ,值得进一步研究和推广应用。
Objective To investigate the repair and reconstruction of large bone defect after resection of bone tumor. Methods From May 1998 to May 2002, according to the site and shape of the bone defect caused by excision of limb bone tumor, we selected allograft bones to be matched with the bone and semi-joint, Or bone, bone repair bone defects, combined with interlocking intramedullary nail or compression plate screw strong internal fixation. Results The group of 22 patients were followed up for 3 to 42 months, 20 cases of tumor-free survival and 2 deaths. One of the patients underwent semi-knee joint transplant rejection, wound healing, percutaneous flap repair is still not healing and amputation; the other 21 cases of patients by X-ray and / or 99m Tc SPECT examination showed unequal amount Callus formation and / or nuclide concentration, suggesting bone healing. Postoperative functional recovery of limbs was assessed by the standard of Markin bone graft evaluation. The excellent and good rate was 81.8%. Conclusion It is an ideal and effective method to repair allograft bone defects after allogeneic bone and joint transplantation. It deserves further research and popularization and application.