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[下肢先天性纤维肉瘤的手术截肢与假肢处理]

[Surgical amputation and prosthetic management in congenital fibrosarcoma of the lower extremity].

作者信息

Zembsch A, Kickinger W, Amann G, Ritschl P

机构信息

I. Abteilung für Orthopädie und orthopäd. Chirurgie, Krankenhaus Gersthof, Wien.

出版信息

Z Orthop Ihre Grenzgeb. 1996 Nov-Dec;134(6):517-9. doi: 10.1055/s-2008-1039917.

Abstract

The concept of surgical amputation and the problems of prosthetic management in a girl with congenital fibrosarcoma of left distal thigh, knee and shank is described. After failed polychemotherapy (EICESS 92) and expansion of the tumor a radical knee disarticulation and intended marginal resection of the tumorous soft tissue area of the distal thigh was performed at the age of eleven months and two weeks. The femur was shortened by osteotomy of the diaphysis and removing a fragment in order to protect the distal femoral epiphyseal growth plate and to be able to close the soft tissue of the stump primarily. Prosthetic fitting and rehabilitation started at the beginning of statomotorical development at the point when four feet standing changed into two feet standing. In present, at the age of two years and six months, this girl is independent mobile and well fitted with a knee disarticulation prosthesis.

摘要

本文描述了一名患有左大腿远端、膝关节和小腿先天性纤维肉瘤的女孩的手术截肢概念及假肢管理问题。在多药化疗(EICESS 92方案)失败且肿瘤增大后,该女孩在11个月零2周时接受了根治性膝关节离断术,并对大腿远端肿瘤性软组织区域进行了预期的边缘切除术。通过骨干截骨术缩短股骨并切除一块骨碎片,以保护股骨远端骨骺生长板,并能够一期闭合残端软组织。当四足站立转变为双足站立,即开始静态运动发育时,便开始进行假肢装配和康复训练。目前,这个女孩两岁零六个月,能够独立活动,所佩戴的膝关节离断假肢适配良好。

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