牵拉成骨术重建骨肉瘤切除后缺损一例报告

Reconstruction of defects following osteosarcoma resection by distraction osteogenesis:1 case report

骨肉瘤为原发恶性骨肿瘤中发病率最高的疾病，致死率及致残率很高，文献报道新辅助化疗后的5年生存率为50％-60％，特别是对于儿童，由于其存在骨骼生长问题，而肿瘤往往侵犯骨骺和干骺端，保肢手术很难避免远期的肢体不等长的问题。牵拉成骨术最早被广泛应用于肢体不等长、骨不愈合、创伤性骨缺损、畸形和骨髓炎的治疗，其在骨肿瘤切除手术的应用并不常见。日本学者Tsuchiya等州最早尝试将骨牵拉延长术应用于骨肿瘤切除后的干骺端、骨骺或骨干的缺损，并取得了一定的效果。

The clinical manifestations, diagnosis and treatment, postoperative follow-up of a 11-year-old female patient with osteosarcoma in the right distal femur were reported. The related research articles at home and abroad were reviewed. The patient underwent distraction osteogenesis for reconstruction following osteosarcoma resection in the right distal femur, and an intramedullary nail was used to maintain the stability during the distraction. The patient was followed up for 112 months. The length was extended by 11cm. The duration of external fixation was 29 months. No local recurrence or lung metastases appeared. Neither wound infection nor pin tract infection was found postoperatively. Neither axial deviation nor re-fracture occurred in the extended femoral segments. The ifnal Musculoskeletal Tumor Society （ MSTS ） score was 90%.