Lenze Ulrich, Baumgart Rainer
Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der TU München, Ismaninger Str. 22, 81675, München, Deutschland.
ZEM - Germany, Zentrum für Extremitätenchirurgie München, Nymphenburger Str. 1, 80335, München, Deutschland.
Orthopadie (Heidelb). 2023 Sep;52(9):729-737. doi: 10.1007/s00132-023-04421-2. Epub 2023 Aug 9.
The reconstruction of extensive bone defects following resection of malignant bone tumours is a challenge and is mainly influenced by tumour-related factors. In defect reconstructions using distraction osteogenesis isotropic, high-quality (new) bone is formed. For the reconstruction of bone defects and secondary limb length discrepancies following tumour resection, predominately three techniques have been described: bone transport, primary shortening and secondary lengthening, as well as "bio-expandable tumour endoprostheses". The use of distraction osteogenesis represents an excellent method for defect reconstruction and treatment of secondary limb length discrepancies following bone tumour resection. Due to the complex anatomical preconditions in tumour patients, a high degree of expertise in distraction osteogenesis (and tumour endoprostheses) is paramount. Therefore, treatment of these patients at highly specialised centres is recommended.
恶性骨肿瘤切除术后广泛骨缺损的重建是一项挑战,主要受肿瘤相关因素影响。在使用等张牵张成骨的缺损重建中,可形成高质量的(新)骨。对于肿瘤切除术后骨缺损和继发性肢体长度差异的重建,主要描述了三种技术:骨搬运、一期缩短和二期延长,以及“生物可扩张肿瘤内置假体”。牵张成骨的应用是骨肿瘤切除术后缺损重建和继发性肢体长度差异治疗的一种优秀方法。由于肿瘤患者解剖条件复杂,牵张成骨(和肿瘤内置假体)方面的高度专业知识至关重要。因此,建议在高度专业化的中心对这些患者进行治疗。