Yang Zhengming, Tao Huimin, Ye Zhaoming, Jin Libin, Lin Nong, Yang Disheng
Department of Orthopaedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.
J Int Med Res. 2018 Aug;46(8):3219-3225. doi: 10.1177/0300060518774992. Epub 2018 May 29.
This study was performed to explore the clinical efficacy of bone transport using external fixation for treatment of large bone defects after tibial tumor resection in five patients. Bone transport started 14 days postoperatively at 1 mm/day and was adjusted according to the callus-to-diameter ratio. The bone transport time, bone graft fusion, relapse, and metastasis were recorded. Clinical efficacy was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system. The tumors included osteosarcoma (n=2), Ewing sarcoma (n=1), malignant schwannoma (n=1), and hemangioma (n=1). The average bone defect length after resection was 11.6 cm. The five patients were followed up for an average of 50.8 months, and the average bone transport time was 15.5 months. Three patients who underwent postoperative chemotherapy were followed for 22.7 months, and two who did not undergo chemotherapy were followed for 4.75 months. Four patients underwent iliac bone grafting, and one underwent vascular pedicle fibular transplantation. The average MSTS score was 21.2 (19.3 for patients who underwent chemotherapy and 24.0 for patients who did not). No relapse or metastasis was observed. Bone transport is effective for reconstruction of large bone defects after tibial tumor resection as well as tibial malignancies with high doses of chemotherapy.
本研究旨在探讨外固定骨搬运治疗5例胫骨肿瘤切除术后大段骨缺损的临床疗效。术后14天开始骨搬运，速度为每天1毫米，并根据骨痂与骨直径的比例进行调整。记录骨搬运时间、骨移植融合情况、复发及转移情况。采用肌肉骨骼肿瘤学会（MSTS）评分系统评估临床疗效。肿瘤包括骨肉瘤（2例）、尤因肉瘤（1例）、恶性神经鞘瘤（1例）和血管瘤（1例）。切除术后平均骨缺损长度为11.6厘米。5例患者平均随访50.8个月，平均骨搬运时间为15.5个月。3例接受术后化疗的患者随访22.7个月，2例未接受化疗的患者随访4.75个月。4例患者接受了髂骨移植，1例接受了带血管蒂腓骨移植。MSTS平均评分为21.2（接受化疗的患者为19.3，未接受化疗的患者为24.0）。未观察到复发或转移。骨搬运对于胫骨肿瘤切除术后大段骨缺损以及高剂量化疗的胫骨恶性肿瘤的重建是有效的。
