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通过多次外科手术、液氮预处理骨肿瘤自体移植、三维外固定和内固定成功矫正一名原发性骨肉瘤患者的胫骨骨畸形:病例报告

Successful correction of tibial bone deformity through multiple surgical procedures, liquid nitrogen-pretreated bone tumor autograft, three-dimensional external fixation, and internal fixation in a patient with primary osteosarcoma: a case report.

作者信息

Takeuchi Akihiko, Yamamoto Norio, Shirai Toshiharu, Nishida Hideji, Hayashi Katsuhiro, Watanabe Koji, Miwa Shinji, Tsuchiya Hiroyuki

机构信息

Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.

Department of Orthopedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

BMC Surg. 2015 Dec 7;15:124. doi: 10.1186/s12893-015-0112-3.

Abstract

BACKGROUND

In a previous report, we described a method of reconstruction using tumor-bearing autograft treated by liquid nitrogen for malignant bone tumor. Here we present the first case of bone deformity correction following a tumor-bearing frozen autograft via three-dimensional computerized reconstruction after multiple surgeries.

CASE PRESENTATION

A 16-year-old female student presented with pain in the left lower leg and was diagnosed with a low-grade central tibial osteosarcoma. Surgical bone reconstruction was performed using a tumor-bearing frozen autograft. Bone union was achieved at 7 months after the first surgical procedure. However, local tumor recurrence and lung metastases occurred 2 years later, at which time a second surgical procedure was performed. Five years later, the patient developed a 19° varus deformity and underwent a third surgical procedure, during which an osteotomy was performed using the Taylor Spatial Frame three-dimensional external fixation technique. A fourth corrective surgical procedure was performed in which internal fixation was achieved with a locking plate. Two years later, and 10 years after the initial diagnosis of tibial osteosarcoma, the bone deformity was completely corrected, and the patient's limb function was good.

CONCLUSION

We present the first report in which a bone deformity due to a primary osteosarcoma was corrected using a tumor-bearing frozen autograft, followed by multiple corrective surgical procedures that included osteotomy, three-dimensional external fixation, and internal fixation.

摘要

背景

在之前的一篇报告中,我们描述了一种使用液氮处理的带瘤自体移植骨进行重建的方法,用于治疗恶性骨肿瘤。在此,我们报告首例经多次手术后通过三维计算机重建对带瘤冷冻自体移植骨后的骨畸形进行矫正的病例。

病例介绍

一名16岁女学生因左小腿疼痛就诊,被诊断为低级别胫骨中央型骨肉瘤。采用带瘤冷冻自体移植骨进行手术骨重建。首次手术后7个月实现骨愈合。然而,2年后出现局部肿瘤复发和肺转移,此时进行了第二次手术。5年后,患者出现19°内翻畸形,接受了第三次手术,术中使用泰勒空间框架三维外固定技术进行截骨。第四次矫正手术采用锁定钢板进行内固定。2年后,即胫骨骨肉瘤初诊后10年,骨畸形完全矫正,患者肢体功能良好。

结论

我们首次报告了使用带瘤冷冻自体移植骨矫正原发性骨肉瘤所致骨畸形,随后进行包括截骨、三维外固定和内固定在内的多次矫正手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a82/4672513/46439913dfe5/12893_2015_112_Fig1_HTML.jpg

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