带血管蒂腓骨移植及人工关节置换修复邻近关节良性骨肿瘤所致骨缺损

Operative treatment of benign bone tumor defects in proximal joint by fibula transplantation with vascular and artificial joint replacement.

目的探讨邻近关节良性骨肿瘤所致骨缺损的修复方法。方法对11例邻近关节之良性骨肿瘤所致骨缺损进行手术处理，其中4例行肿瘤刮除、瘤壁烧灼加植骨术，3例行带血管节段性腓骨移植充填支撑加植骨术，2例行带血管腓骨小头移植重建孟肱及桡腕关节术，2例行人工肿瘤型假体置换术。结果经1．5～6年随访，所有病例骨愈合均满意，肿瘤无复发，其中2例关节功能轻度障碍。结论处理邻近关节的良性骨肿瘤所致骨缺损的修复，应充分考虑腓骨作为移植材料的重要性和修复能力。行人工肿瘤型假体置换应严格掌握适应证。

Objective To explore the reconstructive methods of benign bone tumor defects in proximal joint. Methods Operative treatment was performed in 11 cases with benign bone tumor defects in proximal joint, among whom 4 eases were treated by curettage, cauterization of wall and bone grafting,3 cases were treated by filling branch through segment fibula transplantation with vascular,2 cases were treated by fibula head transplantation with vascular to reconstruct the glenohumeral joint and radiocarpal joint, and 2 cases were treated by artificial joint replacement. Results The follow-up ranged from 1.5 to 6 years. All of cases got excellent bone unioned without relapse and 2 eases of them developed with little limitation in joint function. Conclusion The importance and reconstructive achievement of fibula transplantation in treating the benign bone tumor defects in proximal joint should be thought fully. The indication of artificial tumor prosthesis replacement should be strictly mastered.