吻合血管的腓骨移植重建儿童胫骨肿瘤切除后大段骨缺损Free vascularized fibular transplantation for repairing massive tibia defects after tumor resection in the childhood
李旭升;樊晓海;刘兴炎;甄平;高秋明;薛云;
摘要(Abstract):
[目的]观察吻合血管的腓骨移植修复儿童胫骨良性骨肿瘤切除后骨缺损的临床效果。[方法]自1994~2009年采用吻合血管的腓骨移植治疗儿童胫骨长节段肿瘤切除后的骨缺损12例,肿瘤切除后,采用健侧带血管腓骨移植重建患侧胫骨,切取健侧腓骨长度为7~14 cm,平均长度10.1 cm。术后定期随访,根据影像学检查、Ennek ing评分结果评定疗效。[结果]术后12例患者均获随访,随访时间12个月~4年,平均18个月。Ennek ing评分26~30分10例,20~25分2例,X线片示术后2~4个月内骨性愈合,移植的腓骨均有不同程度增粗,肿瘤无复发。[结论]吻合血管的腓骨移植是修复胫骨良性骨肿瘤切除后大段骨缺损的良好方法。
关键词(KeyWords): 腓骨/移植;胫骨;骨肿瘤;骨缺损
基金项目(Foundation):
作者(Author): 李旭升;樊晓海;刘兴炎;甄平;高秋明;薛云;
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DOI:
参考文献(References):
- [1]Delepine G,Delepine F,Alkallaf S,et al.Long term results of expan-ding prostheses for limb salvage surgery of children[J].Eur J Cancer,2001,37:86.
- [2]Gupta A,Meswania J,Pollock R,et al.Non-invasive distal femoralexpandable endoprosthesis for limb-salvage surgery in paediatrictumors[J].J Bone Joint Surg,2006,88:5.
- [3]Robert JG.Surgical options for children with osteosarcoma[J].LancetOncol,2005,6:85-92.
- [4]Tsuchiya H,Wan SL,Sakayama K,et al.Reconstruction using an au-tograft containing tumour treated by liquid nitrogen[J].J Bone JointSurg,2005,87:2.
- [5]Manabe J,Ahmed AR,Kawaguchi N,et al.Pasteurized autologousbone graft in surgery for bone and soft tissue sarcoma[J].Clin OrthopRelat Res,2004,419:258-266.
- [6]Brigman BE,Hornicek FJ,Gebhardt MC,et al.Allografts about theknee in yong patients with high-grade sarcoma[J].Clin Orthop RelatRes,2004,421:232-239.
- [7]Mankin HJ,Hornicek FJ,Raskin KA.Infection inmassive bone al-lografts[J].Clin Othop Relat Res,2005,432:210-216.
- [8]Neel MD.The use of a periosteal replacement membrane for bone graftcontainment at allograft-host junctions after tumor resection and re-construction with bulk allograft[J].Orthopedics,2003,26:5.
- [9]杜伍岭,秦德安,王源瑞,等.吻合血管的腓骨移植治疗股骨近端骨囊肿二次病理骨折[J].中国矫形外科杂志,2005,14:1074-1075.
- [10]Innocenti M,Ceruso M,Manfrini M,et al.Free vascularized growth-plate transfer after bone tumour resection in children[J].J ReconstrMicrosurg,1998,14:137-143.
- [11]Innocenti M,Delcroix L,Manfrini M,et al.Vascularized proximalfibular epiphyseal transfer for distal radial reconstruction[J].J BoneJoint Surg Am,2004,86:1504-1511.
- [12]Fragnire B,Wicart P,Mascard E,et al.Prevention of ankle valgus af-ter vascularized fibular grafts in children[J].Clin Orthop Relat Res,2003,408:245-251.