Xu Min, Peng Dan, Peng Hongchun, Chen Xia, Li Zheng, Li Zhihong
Department of Orthopedics, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2010 Mar;35(3):267-72. doi: 10.3969/j.issn.1672-7347.2010.03.013.
To investigate the effect and the significance of soft tissue repairing and functional reconstruction in limb salvage operation on extremity malignant bone tumors by individualized prosthesis replacement after malignant tumor resection with the help of Neo-adjuvant chemo-therapy.
A total of 78 patients with malignant bone tumor were recruited, including 42 males and 36 females. Aged 19~61, with an average of (29.12+/-9.47).Tumor in 14 patients was in the proximal humerus, 11 in the proximal femur, 27 in the distal femur, 3 in femoral middle part, and 23 in the proximal tibial. There were 29 cases of osteogenic sarcoma, 18 chondroma sarcomatosum, 7 malignant enchondroma with pathological fracture, 20 malignant giant cell tumor,and 4 malignant inflammatory myofibroblastoma of the bone. Soft tissue repairing and functional reconstruction were carried out together with individualized prosthesis replacement. The type of the prostheses was as follows: 14 patients had long stem humerus head prosthesis, 50 made hinged knee prostheses with femoral or tibial component, 3 whole femur replacements, 7 long stem femoral head prostheses, 4 long stem hip prostheses.
All patients were followed up for an average of (26.80+/-8.06) months (4~37 months) and postoperative functions were estimated according to Enneking system. Among the 78 patients, results in 48 (61.5%) were excellent, 17 (21.8%) were good, 10 (12.8%) were fair, and 3(4.9%) were poor. The satisfactory rate was 83.3%.
Soft tissue repairing and functional reconstruction in limb salvage operation on extremity bone malignant tumors by individualized prosthesis replacement not only spare the limbs, but also keep their function.It can remove the psychologic obstacles caused by extremity absence, and is effective for bone malignant tumor.
探讨新辅助化疗后个体化假体置换在肢体恶性骨肿瘤保肢手术中软组织修复及功能重建的效果及意义。
共纳入78例恶性骨肿瘤患者，其中男性42例，女性36例。年龄19～61岁，平均（29.12±9.47）岁。肿瘤位于肱骨近端14例，股骨近端11例，股骨远端27例，股骨中段3例，胫骨近端23例。骨肉瘤29例，软骨肉瘤18例，伴有病理性骨折的恶性内生软骨瘤7例，恶性骨巨细胞瘤20例，骨恶性炎性肌纤维母细胞瘤4例。行个体化假体置换的同时进行软组织修复及功能重建。假体类型如下：14例采用长柄肱骨头假体，50例采用带股骨或胫骨部件的铰链膝关节假体，3例全股骨置换，7例长柄股骨头假体，4例长柄髋关节假体。
所有患者平均随访（26.80±8.06）个月（4～37个月），术后功能按Enneking系统进行评估。78例患者中，优48例（61.5%），良17例（21.8%），可10例（12.8%），差3例（4.9%）。满意率为83.3%。
个体化假体置换在肢体恶性骨肿瘤保肢手术中进行软组织修复及功能重建，不仅保留了肢体，还保留了其功能。它可以消除肢体缺失所带来的心理障碍，对骨恶性肿瘤有效。
