保留骨骺的保肢技术在治疗青少年膝关节周围骨肉瘤患者中的应用进展

Treatment progress of osteosarcoma around the knee joint in adolescents with epiphysis preservation in limb salvage operation

骨肉瘤是好发于青少年的原发恶性骨肿瘤之一,其好发部位是股骨远端和胫骨近端。随着新辅助化疗在骨肉瘤治疗中的应用,骨肉瘤患者的生存率可达到75%[1]。由于青少年患者的骨骺尚未闭合,如果术中切除骨骺,则势必会造成患者肢体的生长障碍、导致肢体短缩或关节畸形,并出现严重跛行和代偿性脊柱侧凸[2-4]。因此,如何解决青少年骨肉瘤患者术后肢体不等长等问题,已成为近年来骨肉瘤保肢治疗的新热点,保留骨骺的手术则成为解决上述问题的一大创新点[5]。现将就保留骨骺的保肢技术在青少年膝关节周围骨肉瘤患者中的治疗进展作如下综述。

Osteosarcoma is one of the most common primary malignant bone tumors, which attacks the children and adolescents under 20 years. The knee joint, the distal femur and proximal tibia are the most predilection sites. With the emergence of new adjuvant chemotherapy and continuous development of surgical techniques, 5 years＇ survival rate of osteosarcoma patients has been improved. The epiphysis of the adolescent patient has not been closed, so growth disorders will be caused if the epiphysis is removed in operation. In recent years, limb salvage operation with the preservation of the epiphysis has become one focus of osteosarcoma salvage therapy.