半组合式人工半骨盆的研制及其临床应用

DevelopmentandClinicalApplicationofthePartialCombinativePelvicProsthesis

根据正常人体骨盆的形态结构和生物力学特点研制的一种以髋臼部为主体、髂骨翼部和耻、坐骨部为附件的半组合式钛质全表面喷涂陶瓷（Ａｌ２Ｏ３）人工半骨盆，经临床初步应用和随访检查证明，其整体结构符合仿生要求，术中安装方便，固定可靠，适应性较强，术后骨盆和下肢功能恢复良好．半骨盆内切除可采用扩大的Ｓｍｉｔｈ－Ｐｅｔｅｒｓｅｎ或Ｍｏｏｒｅ切口，必要时可联合腹股沟切口，按照切除范围选择适合的人工半骨盆重建骨盆环，同侧用双动锁扣式全髋假体行全髋置换术．文中结合文献复习提出半骨盆置换的适应证为：（１）骨盆原发性低度恶性肿瘤；（２）骨盆单灶性转移癌；（３）髋区尤其是骨盆前部位的巨大溶骨性肿瘤．

Thepartialcombinativepelvicprosthesis,madeofTi-aloyandcoatedwithceramic(Al2O3),wasdevelopedonbasisofthecharacteristicsoftheanatomicalformandbiomechanicsofnor-malhumanpelvis.Afterundergoingprimaryclinicalapplicationsandfolow-upexaminationsitwasdemonstratedthatthestructureofthepelvicprosthesisconformedtobionics,thefixationwasconve-nient,reliableandadaptedtoagreatdegreeintraoperativelyandgoodresultsofthemwereacquired.IntrahemipelvectomywasperformedafterextendedapproachSmith-PetersenorMoore,ifnecessary,combinedwithgroinapproach.Suitablepelvicprosthesiswereselectedtoreconstructthepelvicringac-cordingtotherangeofintrahemipelvectomy.Self-lockingbipolarprosthesiswasusedforthetotalhipreplacement.Theindicationsofhemipelvicprosthesiswereasfolows,(1)lowerdegreeprimarymalig-nantneoplasms,(2)isolatedmetastasisinpelvic,(3)extensiveosteolyticbenigntumorinhipregion.Thereplacementformalignantgrowthshouldbeperformedwithsupportingofradiotherapyandchemotherapy.