Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, NY, USA.
J Surg Oncol. 2013 Mar;107(4):343-52. doi: 10.1002/jso.23217. Epub 2012 Jul 17.
Patients with musculoskeletal tumors can face large bone deficiency, deformity, and nonunion. Distraction osteogenesis via the Ilizarov method may be useful for reconstruction of these deficiencies allowing limb preservation and optimizing function.
We reviewed 20 patients with a range of musculoskeletal tumors necessitating surgical treatment. The group included 9 females and 11 males with a mean age of 22.6 (8-58) years at a mean follow up of 81.7 (26-131) months. The mean bone deficiency was 7.9 (1.2-18.0) cm.
The mean lengthening achieved was 7.1 (3.5-18.0) cm over an EFI of 33.5 (range, 9.5-58.3) days/cm. This treatment resulted in 10 excellent and 3 good ASAMI bone scores, 10 excellent and 3 good ASAMI function scores, a mean lower extremity MSTS score of 93% and a mean upper extremity MSTS score of 87%. Treatment resulted in 2 complications, 18 obstacles, and 6 problems.
The Ilizarov method is an effective technique for limb reconstruction of bone tumors, although extended time in external fixation is required. Since no one in this group received simultaneous chemotherapy or radiotherapy, we cannot comment on use of the Ilizarov method with these treatments. Further use and clinical follow-up is warranted.
患有肌肉骨骼肿瘤的患者可能面临较大的骨缺损、畸形和骨不连。伊里扎洛夫(Ilizarov)法的牵张成骨术可能有助于重建这些缺陷,从而保留肢体并优化功能。
我们回顾了 20 名需要手术治疗的肌肉骨骼肿瘤患者。该组包括 9 名女性和 11 名男性,平均年龄为 22.6(8-58)岁,平均随访时间为 81.7(26-131)个月。平均骨缺损为 7.9(1.2-18.0)cm。
平均延长长度为 7.1(3.5-18.0)cm,外固定指数(EFI)为 33.5(范围 9.5-58.3)cm/d。这种治疗方法导致 10 例 ASAMI 骨评分优秀和 3 例良好,10 例 ASAMI 功能评分优秀和 3 例良好,下肢 MSTS 平均得分为 93%,上肢 MSTS 平均得分为 87%。治疗导致 2 例并发症、18 例障碍和 6 例问题。
伊里扎洛夫(Ilizarov)法是治疗骨肿瘤肢体重建的有效技术,但需要延长外固定时间。由于本组患者均未同时接受化疗或放疗,我们无法对伊里扎洛夫(Ilizarov)法与这些治疗方法的联合应用发表意见。需要进一步使用和临床随访。