跟骨恶性肿瘤保肢治疗的初步观察

Treatment of limb-salvage surgery for calcaneal malignant tumor

目的 探讨跟骨恶性肿瘤的保肢方法。方法 3例跟骨恶性肿瘤病人(2例跟骨软骨肉瘤、1例跟骨腺泡状肉瘤)经区域热或热药灌注后,用煮沸灭活的跟骨加自体腓骨植骨的方法重建。结果 随访24～75个月,3例病人均无肿瘤局部复发,在术后6～10个月能负重独立行走。2例跟骨软骨肉瘤的患者均无瘤生存,但其中1例因伤口感染不愈,术后12个月截肢。1例跟骨腺泡状肉瘤的病人术后75个月死于脑转移。结论 在区域热或热药灌注有效控制局部肿瘤后,灭活跟骨加自体腓骨植骨的保肢方法是可行的。

Objective To explore a method of Limb - salvage surgery for calcancal malignant tumor. Method Three patients with calcaneal malignant tumor (2 patients with calcaneal chondrosarcoma and 1 patient with calcaneal alveolar sarcoma) were reconstructed with boiling devitalized calcaneus and fibulu autograft after hyperthemic antiblastic perfusion (HAP). Result Follow up 24 - 75 months, all of the 3 patients have no local recurrence and can walk with beary weight at 6～10 months after operation. Two patients with calcaneal chondrosarcoma are survival without evidence of tumor, but one of the two patients have to be amputated 12 months after opration because of wound infection. Another patient with calcaneal alveolar sarcoma deid because of brain metastasis at 75 months after operation. Conclusion Limb - salvage surgery with devitalized calcaneus and fibula autograft for calcaneal malignant tumor is available after calcancal local tumor was effectively controlled by HAP.