Tsuchiya H, Wan S L, Sakayama K, Yamamoto N, Nishida H, Tomita K
Kanazawa University, Kanazawa, Japan.
J Bone Joint Surg Br. 2005 Feb;87(2):218-25. doi: 10.1302/0301-620x.87b2.15325.
We describe a method of reconstruction using tumour-bearing autograft treated by liquid nitrogen in 28 patients. The operative technique consisted of en bloc excision of the tumour, removal of soft tissue, curettage of the tumour, drilling and preparation for internal fixation or prosthetic replacement before incubation for 20 minutes in liquid nitrogen, thawing at room temperature for 15 minutes, thawing in distilled water for ten minutes, and internal fixation with an intramedullary nail, plate or composite use of prosthetic replacement. Bone graft or cement was used to augment bone strength when necessary. The limb function was rated as excellent in 20 patients (71.4%), good in three (10.7%), fair in three (10.7%), and poor in two (7.1%). At the final follow-up six patients had died at a mean of 19.8 months after the operation, while 21 remained free from disease with a mean follow-up of 28.1 months (10 to 54). One patient is alive with disease. Bony union was seen at a mean of 6.7 months after the operation in 26 patients. Complications were encountered in seven patients, including three deep infections, two fractures, and two local recurrences. All were managed successfully. Our results suggest that this is a simple and effective method of biological reconstruction.
我们描述了一种在28例患者中使用经液氮处理的带瘤自体移植进行重建的方法。手术技术包括整块切除肿瘤、去除软组织、刮除肿瘤、钻孔并准备内固定或假体置换，然后在液氮中孵育20分钟，在室温下解冻15分钟，在蒸馏水中解冻10分钟，并用髓内钉、钢板进行内固定或联合使用假体置换。必要时使用骨移植或骨水泥增强骨强度。肢体功能评定为优20例（71.4%），良3例（10.7%），可3例（10.7%），差2例（7.1%）。在最后随访时，6例患者在术后平均19.8个月死亡，21例患者无疾病生存，平均随访28.1个月（10至54个月）。1例患者带瘤生存。26例患者术后平均6.7个月出现骨愈合。7例患者出现并发症，包括3例深部感染、2例骨折和2例局部复发。所有并发症均成功处理。我们的结果表明，这是一种简单有效的生物重建方法。
