可调节延长式人工假体研制及在股骨下段恶性骨肉瘤保肢术中的初步应用

EXTENDIBLE REPLACEMENT OF THE DISTAL FEMUR IN THE TREATMENT OF OSTEOSARCOMA IN GROWING INDIVIDUALS

目的探讨可调节延长式人工假体在生长期青少年骨肉瘤保肢治疗中的应用价值。方法1999年12月～2003年3月,研制并应用可调节延长式人工假体修复股骨下段骨肉瘤切除术3例(B型2例,A型1例),其中2例已行假体延长术,1例待行。结果2例患者术后2～3年患肢短缩4～5cm。行假体调节延长术后,患肢与健侧等长,无神经血管牵拉反应。术后分别随访2个月和3年,假体坚固稳定性未见改变,关节功能满意。另1例患者假体置换后无感染、松动,尚未行调节延长手术。结论可调节延长式人工假体置换手术切口小,操作简便可靠,术后无神经血管牵拉反应,不影响假体坚固性。

Objective To investigate the possibility of using extendible distal femoral replacements in the treatment of osteosarcoma in growing individuals. Methods From December 1999 to March 2003, 3 cases (2 were type ⅡB, 1 was type ⅡA) with osteosarcoma were treated by extendible distal femoral replacements. Of the 3 cases, 2 underwent prosthesis extention operation, 1 was not operated. Results After the removal of tumor, the extremities of 2 patients were shortened by 4 to 5 cm within 2 to 3 years. After the lengthening procedure, the affected extremities were of equal length to the unaffected extremities and no drag symptoms of blood vessel and nerves were observed. Follow-up was done for 2 months to 3 years. There was no aseptic loosening. The function of joints was fairly good. Conclusion Extendible distal femoral replacements is an easy, convenient, and effective way to treat osteosarcoma.