Bastian L, Hüfner T, Mössinger E, Geerling J, Goesling T, Busche M, Kendoff D, Bading S, Rosenthal H, Krettek C
Unfallchirurgische Klinik, Medizinische Hochschule, Hannover.
Unfallchirurg. 2003 Nov;106(11):956-62. doi: 10.1007/s00113-003-0680-z.
The resection of primary malignancies in the pelvis is technically demanding as organs and structures are to be preserved and reconstruction of the defect as well as the postoperative function and rehabilitation are dependent on an optimal prosthesis. We present two patients with a sarcoma of the pelvis where for the first time a structured concept of technology integration led to a press-fit implantation of a hemipelvic prosthesis. This concept includes the design and production of a "custom-made" prosthesis as a hemipelvic substitute and the coating of this prosthesis with Bonit, a second-generation calcium phosphate, and gentamycin in watery solution. The tumor resection was done with computer-assisted surgery based on computed tomographies (CT) of the pelvis model done by rapid prototyping rather than on the CT of the patients' pelvis. With this procedure the presurgically simulated resection could be executed precisely with complete resection of the tumors and an accuracy which allowed an exact implantation of the prosthesis. The course was uneventful with primary healing and no sign of an infection or loosening after 6 months.
骨盆原发性恶性肿瘤的切除在技术上要求很高，因为需要保留器官和结构，而缺损的重建以及术后功能和康复取决于理想的假体。我们介绍两名骨盆肉瘤患者，首次采用结构化技术整合概念实现了半骨盆假体的压配式植入。这一概念包括设计和制作“定制”假体作为半骨盆替代品，并在该假体上涂覆第二代磷酸钙Bonit和庆大霉素水溶液。肿瘤切除是基于骨盆模型的计算机断层扫描（CT）通过快速成型技术进行的计算机辅助手术，而非患者骨盆的CT。通过该手术，术前模拟的切除得以精确实施，肿瘤完全切除，且精度足以实现假体的精确植入。术后过程顺利，一期愈合，6个月后无感染或松动迹象。
