Zheng Kai, Yu Xiu-Chun, Cai Jinfang, Xu Ming, Cui Haocheng, Chen Qian, Zhang Jing-Yu
Department of Orthopedics, The 960th Hospital of the PLA Joint Logistice Support Force, Jinan, China.
Department of Bone Tumor, Tianjin Hospital, Tianjin, China.
Orthop Surg. 2025 Feb;17(2):492-499. doi: 10.1111/os.14318. Epub 2024 Dec 12.
Ilizarov technology is highly effective in addressing complex orthopedic challenges. This study aims to describe our experience with distraction osteogenesis in managing bone tumors in the lower extremity, focusing on composite bone defects and associated complications.
A retrospective clinical study was conducted to analyze patients with primary bone tumors who underwent distraction osteogenesis using the Ilizarov method from 2010 to 2020. Some young children received epiphyseal distraction and bone transport as part of their sarcoma surgical treatment. Additionally, external fixation, bone transport, or limb lengthening were employed to address complex postoperative complications associated with bone tumors. The clinical outcomes assessed included the patient's general information, the location of bone defects, the length of bone repair, the status of bone healing, and limb function.
Eleven patients were followed up for an average of 66 months (range, 24-132 months). The average length of repaired bone defects was 13 cm (range, 2.5-32 cm). The cohort comprised three females and eight males, with ages at presentation ranging from 6 to 42 years (mean, 18 years). The sites of involvement included the distal femur (n = 4), femoral diaphysis (n = 3), proximal tibia (n = 2), and the distal tibia (n = 2). Nine patients were diagnosed with osteosarcoma, while one presented with Ewing's sarcoma and another with a giant cell tumor of bone. Three young children were successfully treated with epiphyseal stretching; however, one patient experienced treatment failure. Additionally, seven patients underwent external fixation to address complex postoperative complications, including infection, bone defects, and limb shortening. At the last follow-up, with the exception of one failure, the average Musculoskeletal Tumor Society (MSTS) limb function scores for the remaining 10 patients were 25 (range, 21-30). Three months post-fixator removal, the Asociación Latinoamericana de Oncología (ASAMI) bone score was rated as excellent in 63.6% (7/11) of patients, whereas the ASAMI function score was excellent in 36.4% (4/11) and good in 54.5% (6/11) of cases.
The Ilizarov method demonstrates some clinical value in the resection and reconstruction of bone tumors, as well as in the management of postoperative complications associated with such tumors.
伊利扎洛夫技术在应对复杂的骨科挑战方面非常有效。本研究旨在描述我们在下肢骨肿瘤治疗中应用牵张成骨的经验，重点关注复合性骨缺损及相关并发症。
进行一项回顾性临床研究，分析2010年至2020年期间采用伊利扎洛夫方法接受牵张成骨治疗的原发性骨肿瘤患者。一些幼儿在肉瘤手术治疗中接受了骨骺牵张和骨搬运。此外，还采用外固定、骨搬运或肢体延长来处理与骨肿瘤相关的复杂术后并发症。评估的临床结果包括患者的一般信息、骨缺损部位、骨修复长度、骨愈合状况和肢体功能。
11例患者平均随访66个月（范围24 - 132个月）。修复的骨缺损平均长度为13厘米（范围2.5 - 32厘米）。该队列包括三名女性和八名男性，就诊时年龄在6至42岁之间（平均18岁）。受累部位包括股骨远端（4例）、股骨干（3例）、胫骨近端（2例）和胫骨远端（2例）。9例患者诊断为骨肉瘤，1例为尤因肉瘤，1例为骨巨细胞瘤。三名幼儿成功接受了骨骺牵张治疗；然而，1例患者治疗失败。此外，7例患者接受了外固定以处理包括感染、骨缺损和肢体缩短在内的复杂术后并发症。在最后一次随访时，除1例失败外，其余10例患者的平均肌肉骨骼肿瘤学会（MSTS）肢体功能评分为25分（范围21 - 30分）。去除固定器三个月后，拉丁美洲肿瘤学协会（ASAMI）骨评分在63.6%（7/11）的患者中被评为优秀，而ASAMI功能评分在36.4%（4/11）的病例中为优秀，在54.5%（6/11）的病例中为良好。
伊利扎洛夫方法在骨肿瘤的切除与重建以及与此类肿瘤相关的术后并发症处理中显示出一定的临床价值。
