Shimozaki Shingo, Yamamoto Norio, Shirai Toshiharu, Nishida Hideji, Hayashi Katsuhiro, Tanzawa Yoshikazu, Kimura Hiroaki, Takeuchi Akihiko, Igarashi Kentaro, Inatani Hiroyuki, Kato Takashi, Tsuchiya Hiroyuki
Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
J Orthop Sci. 2014 Jan;19(1):156-63. doi: 10.1007/s00776-013-0487-x. Epub 2013 Oct 25.
Of the biological reconstruction methods for malignant bone and soft tissue tumors, reconstruction with liquid nitrogen has the advantage of maintaining continuity on the distal side of the tumor bone site (pedicle freezing procedure; PFP). This method is expected to result in early blood flow recovery, with early union and low complication rate. The purpose of this study was to compare the outcomes of the PFP and free freezing procedure (FFP) in the lower extremities.
The study included 20 patients (12 men and 8 women) with frozen autografts (FFP, 13 cases; PFP, 7 cases). The mean age of the subjects was 36.3 years (range 11-79 years), and the mean follow-up period was 56.4 months (range 12-142 months).
Final bone union occurred in 11 patients in the FFP group (84.6%) and in 7 patients in the PFP group (100%). The mean union period in patients who did not need additional surgery was 9.8 months (range 4-21 months) in the FFP group and 4.8 months (range 2-7 months) in the PFP group. Postoperative complications occurred in 8 cases: infection in 3 cases, fracture in 3 cases, and joint destruction in 2 cases. Six FFP patients, and 2 PFP patients (two cases of fracture), developed postoperative complications.
The union period was shorter and the rate of postoperative complications was lower with the PFP than with the FFP. We considered that early blood flow recovery might have led to the above results in the PFP.
在恶性骨与软组织肿瘤的生物重建方法中，液氮重建具有保持肿瘤骨部位远端连续性的优势（蒂部冷冻术；PFP）。该方法有望实现早期血流恢复、早期愈合且并发症发生率低。本研究旨在比较下肢PFP与游离冷冻术（FFP）的疗效。
本研究纳入20例接受自体骨冷冻移植的患者（男性12例，女性8例）（FFP组13例；PFP组7例）。受试者的平均年龄为36.3岁（范围11 - 79岁），平均随访期为56.4个月（范围12 - 142个月）。
FFP组11例患者（84.6%）实现最终骨愈合，PFP组7例患者（100%）实现最终骨愈合。无需额外手术的患者中，FFP组的平均愈合时间为9.8个月（范围4 - 21个月），PFP组为4.8个月（范围2 - 7个月）。术后发生并发症8例：感染3例，骨折3例，关节破坏2例。6例FFP患者和2例PFP患者（2例骨折）出现术后并发症。
PFP的愈合时间比FFP短，术后并发症发生率也低于FFP。我们认为，PFP中早期血流恢复可能导致了上述结果。
