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[同种异体骨移植在原发性恶性骨肿瘤骨缺损重建中的应用]

[Allografts in reconstruction of osseous defects in primary malignant bone tumors].

作者信息

Wuisman P, Gohlke F, Witlox A

机构信息

Orthopädische Klinik, Freie Universität Amsterdam, Niederlande.

出版信息

Orthopade. 2003 Nov;32(11):994-1002. doi: 10.1007/s00132-003-0580-5.

Abstract

Reconstruction of large bone defects due to resection of musculoskeletal tumors can be performed with various types of massive homologous allografts. In combination with endoprostheses (composite allografts), various types of osteosyntheses, or autogenous vascularized grafts (most often the fibula), individual adaptation with respect to location, stability, and function is possible. In the elderly most often reconstruction with massive endoprostheses is performed; however, in younger patients limb-saving procedures using autologous material (e.g., rotationplasties) is the most acceptable procedure. Although allografts are of advantage with respect to better anatomic adaptation and thereby to function, the surgeon should be aware of potential drawbacks, especially late complications (fractures, graft resorption, and infection).

摘要

因肌肉骨骼肿瘤切除导致的大骨缺损重建可采用多种类型的大块同种异体骨移植。与假体(复合异体骨)、各种类型的骨固定术或自体带血管移植物(最常见的是腓骨)相结合,可以根据位置、稳定性和功能进行个体化适配。在老年人中,最常采用大块假体进行重建;然而,在年轻患者中,使用自体材料的保肢手术(如旋转成形术)是最可接受的手术方式。尽管异体骨在更好的解剖适配进而功能方面具有优势,但外科医生应意识到潜在的缺点,尤其是晚期并发症(骨折、移植物吸收和感染)。

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