软组织修复重建在保肢治疗四肢恶性骨肿瘤的应用

Soft tissue repair and functional reconstruction in limb salvage treatment of limb malignant bone tumors

目的:探讨切除恶性骨肿瘤后,采用特制人工假体,辅助化疗下行保肢治疗,观察修复软组织和重建功能的可行性。方法:回顾性分析51例恶性骨肿瘤患者的临床资料,骨肿瘤切除后的缺损应用特制人工假体修复,行软组织修复和功能重建。评估标准按照Puri肢体骨骼肿瘤手术治疗重建术,评价保肢术后功能恢复、骨愈合情况及并发症等。结果:51例患者术后均存活,术后功能评估:优27例(52.9%),良11例(21.6%),可7例(13.7%),差6例(11.8%),优良率达74.5%。超过10个月随访时间49例,均骨性愈合,无骨不连和内固定折断现象。结论:采用特制人工假体对四肢恶性骨肿瘤行保肢治疗,可有效的修复软组织和重建功能,有效的克服了患者因肢体缺失带来的心理障碍,是四肢骨骼系统恶性肿瘤有效的治疗途径。

Objective：To study the effect and the significance after resection of malignant bone tumors, adopt special artificial prosthesis, adjuvant chemotherapy descending limb salvage treatment, to observe the feasibility of soft tissue and restore function. Methods：51 cases patients recruited with malignant bone tumors were retrospectively analyzed in our hospital, bone defect after tumor excision repair using special artificial prosthesis, soft tissue repair and functional reconstruction. Evaluation criteria in accordance with the Enneking limb bone tumor surgery revascularization, evaluation the function of limb-salvage surgery recovery, the bone healing and complications, etc. Results：51 cases of postoperative survival, postoperative function assessment：27 cases （52.9%） were excellent, 11 cases （21.6%） were good, 7 cases （13.7%） were fair, 6 cases （11.8%） were poor, the satisfactory rate was 74.5%. 49 cases were follow-up more than 10 months, all osseous healing, no bone nonunion fracture and internal fixation. Conclusion：Adopting the special artificial prosthesis limb salvage treatment of limb malignant bone tumor line, which can effectively repair of soft tissue and rebuild the function, effectively overcome the patients psychological barriers due to missing limbs. Limb skeletal system is effective in treating malignant tumors.