大段同种异体骨移植在骨肿瘤性骨缺损修复中的应用  

Repair of Bone Defect due to Excision of Bone Tumor with Massive Bone Allograft

作　　者：邵增务[1] 杜靖远[1] 杨述华[1] 郑启新[1] 刘勇[1] 廖翔[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022

出　　处：《华中科技大学学报（医学版）》2006年第5期681-683,共3页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨大段深冻同种异体骨及异体半关节移植在治疗四肢骨肿瘤切除后大段骨缺损中的疗效。方法1993年6月～2003年12月应用大段深冻同种异体骨及异体半关节移植治疗四肢骨肿瘤切除后大段骨缺损患者53例，年龄13～58岁，平均36，5岁，其中大段骨移植45例，异体半关节移植8例，异体骨移植长度9～25cm，平均13cm。钢板固定23例，动力髋（或动力髁）固定12例，交锁髓内钉固定12例，普通髓内钉固定6例。结果随访资料完整者48例，术后随访6～132个月，平均38个月，异体骨愈合45例，不愈合3例。主要并发症：复发3例，骨不连3例，感染2例（后治愈），骨折2例，内固定失败1例。关节功能按Mankin标准评定；优18例，良15例，中9例，差6例。结论大段深冻同种异体骨及异体半关节是四肢骨肿瘤切除后大段骨缺损较为理想的修复材料。Objective To investigate the effect of repair of bone defect due to excision of bone tumor with massive bone allograft. Methods Between 1993 and 2003, deep frozen massive bone allograft and osteoartlcular allograft were used in the treatment of bone defect in 53 patients following tumor resection. The age of the patients ranged from 13-58 years （mean 36.5 years）, massive allograft was performed in 45 cases and osteoarticular allograft in 8 cases. The mean length of the allograft was 13 em （9--25 cm）. The types of fixation included plate in 23 cases, dynamic hip screw （or dynamic condylar screw） in 12 cases, interlocking intramedullary nailing in 12 cases and common intramedullary nailing in 6 cases. Results Follow-up period ranged from 6- 132 months （average 38 months） in 48 cases. Forty five cases had union and 3 nonunion. The major complications were recurrence in 3 cases, nonunion in 3 cases, infection in 2 cases, fractures in 2 cases, and loosening and breakage of internal fixation in 1 case. The function was evaluated by Mankin System： 18 cases had excellent outcome, 15 cases good, 9 cases fair and 6 cases poor. Conclusion Deep frozen large segment bone allograft and osteoarticular allograft can be effectively and safely used for repair of bone defect following resection of bone tumor.

关 键 词：骨肿瘤 骨缺损 骨移植 异体骨关节移植 

分 类 号：R738.1[医药卫生—肿瘤]