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采用刮除、骨水泥填充及植骨术治疗的骨巨细胞瘤。

Giant cell tumor of bone treated by curettage, cementation, and bone grafting.

作者信息

Pals S D, Wilkins R M

机构信息

Department of Surgery, Fitzsimons Army Medical Center, Aurora, Colo.

出版信息

Orthopedics. 1992 Jun;15(6):703-8. doi: 10.3928/0147-7447-19920601-07.

Abstract

Giant cell tumor, a relatively rare, occasionally malignant tumor of bone, remains a difficult therapeutic problem for the orthopedic surgeon. Various treatment options, including curettage alone, curettage with bone grafting, radiation, and curettage with acrylic cementation have been utilized and reported. Therapeutic complications such as infection, recurrence, and loss of support of the articular surface have continued to plague the treatment of giant cell tumors. This article reports the results of 10 consecutive cases of giant cell tumor of bone treated by curettage and methyl methacrylate cementation, followed by bone grafting of the surface of the lesion with demineralized bone matrix to reconstitute the cortex at the site of the tumor. At an average follow up of 36 months, eight patients had an excellent functional result and two had a fair result as scored on the Musculoskeletal Tumor Society rating system. To date, there have been no tumor recurrences or metastases, and all patients have radiographic evidence of healing of the weight bearing cortical surface.

摘要

骨巨细胞瘤是一种相对罕见的、偶尔发生恶变的骨肿瘤,对于骨科医生来说,它仍然是一个难以治疗的问题。包括单纯刮除术、刮除植骨术、放疗以及刮除加丙烯酸骨水泥填充术等多种治疗方法都已被应用和报道。诸如感染、复发以及关节面支撑力丧失等治疗并发症一直困扰着骨巨细胞瘤的治疗。本文报告了连续10例采用刮除加甲基丙烯酸甲酯骨水泥填充术治疗的骨巨细胞瘤患者的治疗结果,随后用脱矿骨基质对病变表面进行植骨,以重建肿瘤部位的皮质骨。平均随访36个月,根据肌肉骨骼肿瘤学会评分系统,8例患者功能结果为优,2例为良。迄今为止,尚无肿瘤复发或转移,所有患者的负重皮质骨表面均有影像学愈合证据。

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