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[基于骨肿瘤切除术后分类的骨盆环重建]

[Reconstruction of the pelvic ring based on classification following resection of bone tumors].

作者信息

Tomita K

机构信息

Dept. of Orthopedic Surgery, Kanazawa University School of Medicine.

出版信息

Gan To Kagaku Ryoho. 1988 Apr;15(4 Pt 2-3):1521-7.

PMID:3382224
Abstract

Bone tumors in the pelvis (28 cases), which had been treated surgically were classified into types I to V and their subtypes A and B, according to the location and range of tumor resection, and were assessed with regard to both the method of reconstruction used and restoration of function. Type I-A, -B (6 cases) did not require any reconstruction of the pelvic ring. However, with type I -B, some difficulty was experienced in maintaining balance upon sitting for a long period. Type II (3 cases) included cases of resection of the anterior part of the pelvis, resulting in loss of ring continuity, but reconstruction was not necessary. In type III -A, the acetabulum excluding the hip joint (1 case) was resected and arthrodesis of the ilium and the femoral head performed. In type III -B the acetabulum with the hip joint was resected (2 cases) followed by replacement of the pelvis and hip joint with an artificial prosthesis. Type N included cases (5) of partial (-A) or total (-B) sacroiliac resection, both of which needed massive bone grafting to reconstruct the pelvic ring. Type V (7 cases) required partial (A) or total (B), resection of the sacrum dynamic reconstruction by spinal instrumentation and massive bone grafting. Among 13 cases of primary malignant bone tumors for which tumor resection was performed, 3 cases recurred. This classification was useful for comparing the surgical modalities of tumor resection, reconstruction and their functional results. Our method of total sacral resection was also introduced.

摘要

对28例接受手术治疗的骨盆骨肿瘤,根据肿瘤切除的部位和范围分为I至V型及其亚型A和B,并对所采用的重建方法和功能恢复情况进行评估。I - A型、I - B型(6例)无需对骨盆环进行任何重建。然而,I - B型患者在长时间坐立时保持平衡存在一定困难。II型(3例)包括骨盆前部切除病例,导致骨盆环连续性丧失,但无需重建。III - A型切除了不包括髋关节的髋臼(1例),并对髂骨和股骨头进行了关节固定术。III - B型切除了包含髋关节的髋臼(2例),随后用人造假体置换骨盆和髋关节。IV型包括部分(- A)或全部(- B)骶髂关节切除病例(5例),两者均需大量植骨以重建骨盆环。V型(7例)需要部分(A)或全部(B)切除骶骨,通过脊柱内固定和大量植骨进行动态重建。在13例接受肿瘤切除的原发性恶性骨肿瘤病例中,有3例复发。这种分类方法有助于比较肿瘤切除、重建的手术方式及其功能结果。还介绍了我们的全骶骨切除方法。

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