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目的:研究腓肠肌内侧头转移在胫骨近端恶性肿瘤(骨肉瘤)保肢治疗中的应用价值。方法:10例胫骨近端恶性肿瘤(骨肉瘤)广泛切除后利用人工假体重建骨和关节,同时用局部带血管蒂的腓肠肌内侧头转移重建软组织缺损,并与髌韧带止点缝合重建伸膝装置,术后一周给予近距离后装放疗,2周后开始规律化疗。随访时间6～21个月,平均13个月。最终结果按Enneking标准评估。结果:与即往11例无腓肠肌肌瓣转移的保肢病例相比,本组10例病人切口全部一期愈合,有效地避免了切口并发症,患肢功能提高,假体表面皮肤移植性好。结论:带血管蒂的腓肠肌内侧头转移用于胫骨近端骨肉瘤保肢术中,能降低伤口并发症,并有助于患肢功能恢复。
Objective: To study the clinical value of medial head gastrocnemius muscle replacement in the treatment of proximal tibial malignant tumors (osteosarcoma). Methods: Ten cases with proximal tibial malignant tumors (osteosarcoma) were reconstructed by artificial prosthesis after extensive resection. At the same time, the soft tissue defect was reconstructed by the medial head of gastrocnemius with local pedicled pedicle and the extensor knee was reconstructed with the patellar ligament Device, a week after surgery to give short-term after radiotherapy, 2 weeks after the beginning of regular chemotherapy. Follow-up time of 6 to 21 months, an average of 13 months. The final result is based on the Enneking criteria. RESULTS: Compared with the limb salvage limbs, the wounds of 10 patients without gastrocnemius muscle flap were all healed in one time, which effectively avoided incision complications, improved limb function and good skin graft on the prosthesis surface . CONCLUSIONS: The medial head of gastrocnemius with vascularisation is used in the limb salvage surgery of proximal tibial osteosarcoma, which can reduce the complications of wound and help the recovery of limb function.