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恩宁克 I/I + IV 型切除术后采用不同棒-螺钉系统进行骨盆重建的临床研究

Pelvic reconstruction with different rod-screw systems following Enneking type I/I + IV resection: a clinical study.

作者信息

Lin Peng, Shao Youyou, Lu Huigen, Zhang Zhengliang, Lin Haiqing, Wang Shengdong, Li Binghao, Li Hengyuan, Wang Zhan, Lin Nong, Ye Zhaoming

机构信息

Department of Orthopaedics, The Second Affiliated Hospital of Zhejiang University School of Medicine/Orthopedics Research Institute of Zhejiang University, Hangzhou 310009, China.

Department of Orthopaedics, Taizhou Hospital of Zhejiang Province, Linhai 317000, China.

出版信息

Oncotarget. 2017 Jun 13;8(24):38978-38989. doi: 10.18632/oncotarget.17164.

Abstract

The mechanical outcomes of patients with pelvic bone tumors involving zone I or zone I + IV who received resection and different reconstructions are not clear. Therefore, the purpose of this study was to compare the outcomes of different rod-screw systems in reconstruction for these patients, and evaluate the relative risk of mechanical failure for them. We reviewed 30 patients for a mean duration of 40.4 months of follow-up (range, 13.1-162.2 months), five patients had mechanical complications. The mechanical survival rate of two-rod and four-screw (TRFS) group was significantly higher than one-rod and two-screw (ORTS) group (p = 0.000). The implant survival rate was correlated with ages (p = 0.010), younger people are more likely to fail. Thus, TRFS fixation for pelvic reconstruction after Enneking type I/I + IV resection can provide better short to long-term mechanical stability compared with ORTS fixation, the strength of ORTS fixation is not enough. In addition, biological reconstruction such as autologous bone graft is recommended for the patients who are younger or suffered from benign tumor. As for the patients who are older, with malignant tumors, underwent adjuvant radiotherapy or chemotherapy, functional reconstruction with bone cement is a good choice.

摘要

涉及I区或I + IV区的骨盆骨肿瘤患者接受切除及不同重建后的力学结果尚不清楚。因此,本研究的目的是比较这些患者不同棒-螺钉系统重建的结果,并评估其力学失败的相对风险。我们回顾了30例患者,平均随访时间为40.4个月(范围13.1 - 162.2个月),其中5例出现力学并发症。双棒四螺钉(TRFS)组的力学生存率显著高于单棒双螺钉(ORTS)组(p = 0.000)。植入物生存率与年龄相关(p = 0.010),年轻人更易失败。因此,与ORTS固定相比,Enneking I型/I + IV型切除术后采用TRFS固定进行骨盆重建可提供更好的短期至长期力学稳定性,ORTS固定强度不足。此外,对于年轻或患有良性肿瘤的患者,建议进行自体骨移植等生物学重建。对于年龄较大、患有恶性肿瘤、接受过辅助放疗或化疗的患者,采用骨水泥进行功能重建是一个不错的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b91/5503588/58d6fdc195e2/oncotarget-08-38978-g001.jpg

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