Wang Wei, Wang Yan, Bi Wenzhi, Yang Jing, Han Gang, Ia Jinpeng, Xu Meng, Liu Guiqi
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014 Mar;28(3):331-4.
To investigate the short-term effectiveness of allogeneic bone transplantation for pelvic reconstruction of large skeletal defects after tumor resection.
Between January 2008 and November 2009, 9 patients with pelvic tumor were treated, and the clinical data were retrospectively analyzed. There were 1 male and 8 females with an average age of 36.1 years (range, 18-44 years). There were 5 cases of giant cell tumor of bone, 2 cases of chondrosarcoma, 1 case of malignant giant cell tumor of bone, and 1 case of Ewing sarcoma. According to the Enneking system for staging musculoskeletal tumors, the lesion involved ilium (region I) in 4 cases, acetabulum (region II) in 6 cases, pubis and ischium (region III) in 3 cases, and sacrum (region IV) in 1 case. The average disease duration was 6.8 months (range, 1-36 months). After accurate resection of the tumor, allograft ilium with or without acetabulum was used in 6 cases and 2 cases respectively, and allogenous bone plate in 1 case for pelvic reconstruction; total hip arthroplasty was performed in 6 cases; sacrum screw was used in 1 case.
Infection of incision and abdominal distention occurred in 1 case, and was cured after debridement; primary healing of incision was obtained in the other cases, without infection, lower limb deep venous thrombosis, or dislocation. The average follow-up was 11.8 months (range, 8-15 months). The X-ray films showed breakage of plate in 1 case at 8 months after operation and partial bone resorption in 2 cases; good position of the prosthesis, plate, and transplanted bone was observed in the other cases. No local recurrence was found. At last follow-up, the average musculoskeletal tumor score (MSTS) was 23 (range, 18-29).
Allogeneic bone transplantation for pelvic reconstruction of large skeletal defects after tumor resection can achieve satisfactory short-term surgical and functional effectiveness.
探讨同种异体骨移植用于肿瘤切除术后骨盆大骨缺损重建的短期疗效。
回顾性分析2008年1月至2009年11月间收治的9例骨盆肿瘤患者的临床资料。其中男性1例,女性8例,平均年龄36.1岁(18 - 44岁)。骨巨细胞瘤5例,软骨肉瘤2例,骨恶性巨细胞瘤1例,尤因肉瘤1例。根据Enneking肌肉骨骼肿瘤分期系统,病变累及髂骨(I区)4例,髋臼(II区)6例,耻骨和坐骨(III区)3例,骶骨(IV区)1例。平均病程6.8个月(1 - 36个月)。肿瘤精确切除后,分别采用带或不带髋臼的同种异体髂骨6例和2例,同种异体骨板1例用于骨盆重建;6例行全髋关节置换术;1例行骶骨螺钉固定。
1例发生切口感染和腹胀,经清创后治愈;其余病例切口一期愈合,无感染、下肢深静脉血栓形成或脱位。平均随访11.8个月(8 - 15个月)。X线片显示1例术后8个月钢板断裂,2例部分骨吸收;其余病例假体、钢板及移植骨位置良好。未发现局部复发。末次随访时,平均肌肉骨骼肿瘤评分(MSTS)为23分(18 - 29分)。
同种异体骨移植用于肿瘤切除术后骨盆大骨缺损重建可取得满意的短期手术及功能疗效。