Schinhan M, Funovics P, Dominkus M, Windhager R
Universitätsklinik für Orthopädie, Medizinische Universität Wien, AKH Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
Oper Orthop Traumatol. 2012 Jul;24(3):235-45. doi: 10.1007/s00064-011-0069-z.
Bone defect reconstruction with growing prostheses after resection of malignant bone tumors using the technique of extendable prostheses.
Limb salvage surgery after resection of primary malignant bone tumors in the growing skeleton for expected leg length deficiencies > 4 cm.
Palliative tumor resection, infection, systemic metastases at the time of diagnosis, social contraindications, lack of compliance of the patient and/or family.
Wide resection of the tumor with resection of the biopsy location. Reconstruction with the growing prosthesis. Planned lengthening operations.
Mobilization with crutches, weight bearing or partial weight bearing according the prosthesis' fixation. Chemotherapy as defined in the chemotherapy protocol. Planned minimally invasive lengthening or noninvasive lengthening according to the type of growing module.
Since 1969, more than 8,632 patients have been registered in the Vienna Bone and Soft Tissue Tumor Registry. Of these, 691 patients suffered from osteosarcoma and 243 from Ewing's sarcoma. A total of 513 patients were < 18 years of age (54.4%). Since 1987, 71 patients have been treated with growing prostheses: 13 patients died of disease, and 44 patients reached maturity. The overall 5- and 10-year survival were 84% and 77%, respectively. The patient group consisted of 26 girls and 18 boys, mean age at surgery 10 ± 3 years. The diagnosis was 34 osteosarcoma and 10 Ewing's tumors. The patients had a mean of 4 ± 3 elongation procedures to reach an elongation of 72.5 ± 53.45 mm. The average elongation per procedure was 14.83 ± 4.6 mm.
采用可延长假体技术，在切除恶性骨肿瘤后用生长型假体进行骨缺损重建。
预计肢体长度缺损>4cm的生长发育期骨骼原发性恶性骨肿瘤切除术后的保肢手术。
姑息性肿瘤切除、感染、诊断时存在全身转移、社会禁忌证、患者和/或家属依从性差。
广泛切除肿瘤及活检部位。用生长型假体进行重建。计划延长手术。
根据假体固定情况，使用拐杖活动，负重或部分负重。按照化疗方案进行化疗。根据生长模块类型计划进行微创延长或无创延长。
自1969年以来，维也纳骨与软组织肿瘤登记处已登记8632多名患者。其中，691例患者患有骨肉瘤，243例患有尤因肉瘤。共有513例患者年龄<18岁（54.4%）。自1987年以来，71例患者接受了生长型假体治疗：13例患者死于疾病，44例患者达到成年期。总体5年和10年生存率分别为84%和77%。患者组包括26名女孩和18名男孩，手术时平均年龄为10±3岁。诊断为34例骨肉瘤和10例尤因肿瘤。患者平均进行4±3次延长手术，延长长度达72.5±53.45mm。每次手术的平均延长长度为14.83±4.6mm。
