Noguchi Masataka, Mizobuchi Hiroo, Kawasaki Motohiro, Ueta Eiki, Okanoue Yusuke, Taniwaki Yoshimichi, Tani Toshikazu
Department of Orthopaedic Surgery, Kochi Medical School, Japan.
J Reconstr Microsurg. 2008 Oct;24(7):525-30. doi: 10.1055/s-0028-1088236. Epub 2008 Sep 16.
The use of pasteurized autologous bone graft has been an innovation in limb-salvage surgery; however, its principal disadvantage is fracture, infection, pseudoarthrosis, and bone resorption. We present two cases in which an intramedullary free vascularized fibular graft combined with pasteurized autologous bone graft was performed for immediate femur or tibia reconstruction following osteosarcoma resection. The rationale of this method is to combine the mechanical strength of a pasteurized bone with the biological activity of a vascularized bone. The pasteurized bone graft provides bone stock and early stability and the addition of the vascularized bone graft substantially facilitates host-pasteurized bone union. This combination procedure may be a recommended option for reconstruction of the lower leg, preserving knee joint function for patients with osteosarcoma.
使用经巴氏消毒的自体骨移植是保肢手术中的一项创新；然而，其主要缺点是骨折、感染、假关节形成和骨吸收。我们介绍两例病例，其中在骨肉瘤切除术后，采用髓内游离带血管腓骨移植联合经巴氏消毒的自体骨移植进行即刻股骨或胫骨重建。该方法的基本原理是将经巴氏消毒骨的机械强度与带血管骨的生物活性相结合。经巴氏消毒的骨移植提供骨量和早期稳定性，而带血管骨移植的加入则大大促进宿主与经巴氏消毒骨的愈合。这种联合手术可能是重建小腿、为骨肉瘤患者保留膝关节功能的推荐选择。
