性别和植入物内固定方式影响瘤段骨酒精灭活再植后的骨愈合

Gender and implant fixation affect the healing of alcohol-inactivated bone

背景:恶性骨肿瘤的瘤段骨酒精灭活再植治疗在临床长期有应用价值,但深入探讨再植后骨愈合情况的研究较少。目的:总结分析影响瘤段骨酒精灭活再植后骨愈合的因素。方法:纳入21例恶性骨肿瘤患者,其中男8例,女13例,年龄7-56岁,均接受瘤段骨酒精灭活再植治疗,其中采用钢板螺钉内固定17例,髓内针固定4例,随访观察骨愈合情况,分析影响瘤段骨灭活再植骨愈合的相关因素。结果与结论:(1)21例患者随访2-6年,平均3.8年;(2)骨愈合患者11例,其中男1例,女10例,平均年龄20.8岁,灭活再植骨长度17.36cm,均采用钢板螺钉内固定,平均骨愈合时间20个月;(3)骨未愈合患者10例,其中男7例,女3例,平均年龄20.5岁,灭活再植骨长度16.10 cm,4例采用髓内针内固定,6例采用钢板内固定;(4)骨愈合组与骨未愈合组平均年龄、平均灭活再植骨长度比较差异无显著性意义,两组性别、内固定方式比较差异有显著性意义(P <0.05);(5)结果表明,年龄、灭活再植骨长度对瘤段骨酒精灭活再植的骨愈合无显著影响,女性患者、钢板内固定是瘤段骨酒精灭活再植治疗后骨愈合的有利因素。

BACKGROUND:Alcohol inactivated replantation is widely used in the treatment of malignant bone tumors,but the postoperative bone healing is little reported.OBJECTIVE:To analyze the related factors affecting the bone healing of the autograft bone after alcohol inactivated replantation.METHODS:Twenty-one patients with malignant bone tumor who received alcohol-inactivated autograft bone replantation were enrolled,including 8 males and 13 females with an age of 7-56 years.Among which,17 cases underwent plate-screw internal fixation,and 4 cases received intramedullary nailing fixation.All patients were followed up to observe the bone healing.The related factors of the autograft bone healing were analyzed.RESULTS AND CONCLUSION:(1)The follow-up time was 2-6 years,with an average of 3.8 years.(2)Eleven patients(1 male and 10 females,with an average age of 20.8 years)achieved bone union,the average length of autograft bone was 17.36 cm,all fixed using plates,and the average healing time was 20 months.(3)Bone nonunion occurred in 10 patients(7 males and 3 females,with an average age of 20.5 years),the average length of autograft bone was 16.10 cm,4 cases of intramedullary nailing fixation,and 6 cases of plate-screw fixation.(4)The differences in the average age and average length of autograft bone were insignificant between two groups.The sex and internal fixation ways showed significant differences between two groups(P<0.05).(5)These results suggest that the age and the length of the autograft bone have no significant effect on autograft bone healing.The female patients and plate-screw internal fixation are beneficial for bone healing after alcohol inactivated replantation.