Niethard Maya, Tiedke Carmen, Andreou Dimosthenis, Traub Frank, Kuhnert Mario, Werner Mathias, Tunn Per-Ulf
Centre of Orthopedic and Trauma Surgery, Department of Oncologic Surgery, Sarcoma Centre Berlin-Brandenburg, HELIOS Klinikum Berlin Buch, Schwanebecker Chaussee 50, 13125 Berlin, Germany.
Sarcoma. 2013;2013:205832. doi: 10.1155/2013/205832. Epub 2013 Apr 16.
This paper deals with bilateral vascularized fibular grafts (BVFG) as a method for reconstruction of metadiaphyseal defects of the femur and tibia in young patients suffering from malignant bone tumors of the lower limb. This reconstructional technique was used in 11 patients undergoing metadiaphyseal resection of lower limb malignant bone tumors. All patients with Ewing's sarcoma and osteosarcoma had multimodal treatment according to the EURO-E.W.I.N.G 99 or COSS-96 protocol. Median FU was 63 months. None of the patients experienced local recurrence during FU. 2 patients died due to distant disease during FU. Full weight- bearing was permitted after a mean of 8 months. The median MSTS score was 87%. Complications occurred in five patients. None of the complications led to failure of the biological reconstruction or to amputation. Biological reconstruction of osseous defects is always desirable when possible and aims at a permanent solution. Good functional and durable results can be obtained by using BVFG for the reconstruction of metadiaphyseal defects of the femur and tibia. Radiotherapy in the multimodal setting increases the risk for graft or fixation failure.
本文探讨双侧带血管蒂腓骨移植术（BVFG），作为一种为患有下肢恶性骨肿瘤的年轻患者重建股骨和胫骨干骺端缺损的方法。该重建技术应用于11例接受下肢恶性骨肿瘤干骺端切除术的患者。所有尤因肉瘤和骨肉瘤患者均按照EURO-E.W.I.N.G 99或COSS-96方案接受多模式治疗。中位随访时间为63个月。随访期间无患者出现局部复发。2例患者在随访期间因远处疾病死亡。平均8个月后允许完全负重。中位肌肉骨骼肿瘤协会（MSTS）评分为87%。5例患者出现并发症。无一例并发症导致生物重建失败或截肢。只要有可能，骨缺损的生物重建总是可取的，其目的是实现永久性解决方案。使用BVFG重建股骨和胫骨干骺端缺损可获得良好的功能和持久的效果。多模式治疗中的放疗会增加移植或固定失败的风险。
