许宋锋;于秀淳;徐明;宋若先;付志厚;

• 1:济南军区总医院骨病科

摘要(Abstract)：

[目的]探讨内侧腓肠肌瓣前移在胫骨上段骨肿瘤保肢手术中重建伸膝装置的临床价值与疗效。[方法]2004年4月~2010年1月,对23例胫骨上段恶性或侵袭性骨肿瘤患者行保肢手术同时应用"腓肠肌瓣前移+髌腱固定"重建伸膝装置。男16例,女7例。年龄10~76岁,平均27岁。骨肉瘤12例,骨巨细胞瘤9例,滑膜肉瘤1例,骨恶性纤维组织细胞瘤1例。23例中行瘤段灭活再植术11例,瘤段切除肿瘤型旋转铰链膝关节假体置换术7例,灭活自体骨复合肿瘤假体置换术5例。术后采用MSTS评分系统评价患肢功能。[结果]所有患者均获随访,平均28个月(3~63个月)。除1例因肺转移死亡外,余22例患肢功能评分为19~28分,平均24分。3例术后出现暂时性腓总神经麻痹;3例出现皮肤坏死、窦道渗液,经植皮、抗感染治疗后痊愈。[结论]胫骨上段骨肿瘤保肢手术治疗时以"腓肠肌瓣前移+髌腱固定"重建伸膝装置,可以实现生物性重建,有利于患膝功能恢复,降低感染、皮肤坏死等并发症的发生率。

关键词(KeyWords)： 骨肿瘤;腓肠肌瓣;髌腱;伸膝功能;膝关节置换;酒精灭活

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 许宋锋;于秀淳;徐明;宋若先;付志厚;

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参考文献(References)：

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