复杂股骨缺损的骨与血管同步重建。
Simultaneous reconstruction of the bone and vessels for complex femoral defect.
作者信息
Miyamoto Shimpei, Fujiki Masahide, Setsu Nokitaka, Kawai Akira
机构信息
Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 1040045, Japan.
Division of Orthopedic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 1040045, Japan.
出版信息
World J Surg Oncol. 2016 Nov 18;14(1):291. doi: 10.1186/s12957-016-1037-8.
BACKGROUND
Several methods have been reported for intercalary reconstruction of femoral defects. Of these, free vascularized fibula grafts (FVFG) are preferred because of their durability, bone-healing potential, and tolerance to infection. If the bone tumor invades the femoral vessels, simultaneous vascular reconstruction also becomes necessary and significant technical hurdles make limb salvage difficult.
CASE PRESENTATION
We present a 10-year-old girl who underwent limb-sparing surgery for a distal femur osteosarcoma. The femoral defect was 15 cm long, and the femoral vessel defect was 10 cm long. The femur was reconstructed with bilateral FVFG, and the femoral vessels were reconstructed with saphenous vein grafts. The grafts survived without vascular compromise, and the affected limb was preserved successfully.
CONCLUSIONS
Combined use of bilateral FVFG and autologous vein grafts makes limb-sparing surgery for a large osteosarcoma of the femur possible.
背景
已有多种用于股骨缺损节段性重建的方法被报道。其中，游离带血管腓骨移植术（FVFG）因其耐久性、骨愈合潜力和抗感染能力而更受青睐。如果骨肿瘤侵犯股血管，同时进行血管重建也变得必要，且重大的技术障碍会使保肢手术困难重重。
病例报告
我们介绍一名10岁接受股骨远端骨肉瘤保肢手术的女孩。股骨缺损长15厘米，股血管缺损长10厘米。采用双侧FVFG重建股骨，并用大隐静脉移植重建股血管。移植组织存活且未出现血管并发症，患侧肢体得以成功保留。
结论
联合使用双侧FVFG和自体静脉移植可使股骨大骨肉瘤的保肢手术成为可能。
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