大段异体骨移植重建股骨肿瘤性缺损

Large Segment Bone Allograft Reconstruction Following Femur Tumors Resection

目的探讨大段异体骨移植在股骨肿瘤扩大切除后缺损重建中的作用及临床效果。方法回顾性分析从2005年1月至2010年1月共30例患者。均行股骨肿瘤保肢手术并采用大段异体骨重建肿瘤切除后缺损的患者。结果 22例患者获得随访,8例患者失访。10例患者死于多发转移。12例存活的患者随访时间为20个月至7年,平均随访时间4.2年。所有患者术后X线片显示异体骨位置良好。6例发生延迟愈合或不愈合。其中有5例发生应力性骨折,1例患者发生深部感染。2例患者发生内固定失败。1例患者局部复发。所有患者中未发现明显的排斥反应。结论大段异体骨移植能够获重建股骨肿瘤后较大的骨缺损,满足了部分股骨肿瘤保肢治疗的需要,是股骨肿瘤保肢治疗中一种可以选择的方法。

Objective Probe into the feasibility of the clinical outcome of large segment bone allograft for reconstruc- tion of the defect after femur tumor resection. Methods During January 2005 to January 2010, 30 patients were car- ded out limb-sparing surgery due to femur tumors, and large segment bone allograft was used to reconstruction the bone defects after tumor resection. Results 22 patients were followed up; 8 patients were lost of follow-up. 10 pa- tients died of generalized metastases. Patients were followed up from 20 months to 7 years. The mean follow-up was 4.2 years. There were 6 patients had delayed union or nonunion, 5 patients had stress fractures, 1 patient occurred primary deep infection. Failure of the internal fixation system occurred in 2 patients, lpatient had local recurrences. No evident immune rejection was observed. Conclusions Large segment bone allograft can meet to the present de- mand in reconstruction of the massive defect following femur tumor resection, and still to be a very useful alternative to prosthesis in limb-sparing surgery of femur tumors.