Gebhart M J, McCormack R R, Healey J H, Otis J C, Lane J M
Clin Orthop Relat Res. 1987 Mar(216):179-82.
The survival of patients with bone sarcomas has improved dramatically with the advent of modern chemotherapeutic regimens, fostering a present trend toward limb sparing procedures. In skeletally immature patients, prosthetic replacement of resected bones and joints is unrealistic because of continued expected growth in the limbs. A stump-lengthening procedure, the reduction-rotation-plasty, has become a valuable alternative to high above-knee amputation. A rhombus-shaped skin incision around the thigh and calf, originally described by Kotz and Salzer, led to a significant discrepancy of the circumference of the proximal and distal skin borders. A circumferential skin incision at the midthigh and a fishmouth-shaped incision at the upper calf was designed to decrease this disproportion. This incision has been used in five consecutive patients with osteosarcoma about the knee. The cosmetic results were excellent, prosthetic fittings were facilitated, and neither vascular nor wound healing problems were encountered.
随着现代化疗方案的出现，骨肉瘤患者的生存率有了显著提高，这促使目前出现了保肢手术的趋势。在骨骼未成熟的患者中，由于肢体预期会持续生长，对切除的骨骼和关节进行假体置换是不现实的。一种残端延长手术，即旋转截骨延长术，已成为高位膝上截肢的一种有价值的替代方法。最初由科茨和萨尔泽描述的围绕大腿和小腿的菱形皮肤切口，导致近端和远端皮肤边缘的周长存在显著差异。在大腿中部做环形皮肤切口，在上小腿做鱼嘴形切口，旨在减少这种差异。该切口已连续应用于5例膝关节周围骨肉瘤患者。美容效果极佳，便于假肢安装，且未出现血管或伤口愈合问题。
