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背景与目的:肢体骨肿瘤保肢手术治疗不仅要彻底切除病灶,而且要保留肢体功能,临床上已有用于修复大段骨缺损的异体骨保存方法。有:新解冷冻骨、冷冻干燥骨和脱钙骨等。深低温及深低温脱水后保存的异体骨有抗原性弱,易与宿主骨结合,新骨形成等优点。现对深低温保存的同种异体骨半关节移植治疗股骨远端肿瘤的保肢手术及其愈后进行分析。方法:采用大段同种异体骨修复股骨远端肿瘤瘤段切除后骨缺损6例,术后用X线片与核素99Tcm—MDP(亚甲基二磷酸)骨骼显像比较评定骨愈合,并评估其功能恢复情况。结果:手术后3~6个月在X线片显示牢固的生物固定(坚强的外骨痂或已骨性连接),核素99Tcm—MDP骨骼显像在骨移植后1个月就显示骨结合部代谢活跃,术后4月局部骨代谢趋于稳定,2年后逐渐恢复正常。本组优2例,良2例,中1例,差1例。结论:深低温保存同种异体骨的半关节移植治疗股骨远端肿瘤,术后移植骨与自体骨愈合良好,核素99Tcm—MDP骨骼显像显示移植骨早期骨存活较X线片敏感,关节功能重建方面到达良好表现。
BACKGROUND & OBJECTIVE: limb salvage limb salvage surgery not only to complete removal of lesions, but also to retain limb function, clinically available for the repair of large bone defects of allogeneic bone preservation methods. There are: fresh solution frozen bone, freeze-dried bone and decalcified bone. Cryogenic and deep cryogenic dehydration after the preservation of allogenic bone with antigenic weak, easily with the host bone, the formation of new bone and so on. Now cryogenic preservation of allogeneic bone and joint transplantation for the treatment of distal femoral limb salvage surgery and prognosis. Methods: Six cases of bone defect after resection of distal femur tumor segment were repaired by large bone allograft. Postoperative radiographs were compared with 99Tcm-MDP (methylene diphosphate) bone scintigraphy to evaluate bone healing, And assess their functional recovery. RESULTS: Three to six months postoperatively, a solid biopsy (strong extra calluses or osseous ligation) was shown on the radiographs and the 99Tcm-MDP bone scintigraphy showed a bone-binding site at 1 month after bone transplantation Metabolic activity, local bone metabolism in April after stabilization, gradually returned to normal after 2 years. Excellent in 2 cases in this group, good in 2 cases, in 1 case, poor in 1 case. CONCLUSION: Hemiarthroplasty with allogeneic bone preserved in deep hypothermia treatment of distal femur tumor, bone graft and autologous bone healing well, radionuclide 99Tcm-MDP bone imaging showed early bone graft survival than X-ray film, joint Function reconstruction to achieve good performance.