自制骨水泥塑形模具在股骨肿瘤大段骨缺损中的应用  

Self-made bone cement body mold in repair of long bone segmental defect following femoral tumor resection

作　　者：王斌[1] 朱忠[1] 陈海啸[1] 林列[1] 马毅[1] 徐国成[1] 章文杰[1] 孙丽娜[1] 

机构地区：[1]浙江省台州医院骨科,浙江临海317000

出　　处：《临床骨科杂志》2009年第3期275-277,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨保肢手术中应用自制骨水泥注入式管状骨塑形模具修复股骨大段骨缺损的疗效。方法自制骨水泥注入式管状骨塑形模具修复股骨大段骨缺损5例。取普通无菌塑料注射器3副,第1副裁取3/4管径作为管状模具主体,套入股骨缺损区;第2副裁取1/2管径并打一注入孔作为模具筒盖;骨水泥装入第3副针筒一次性加压注入管状模具。结果5例均获随访,时间18～54个月。术后切口均一期愈合,无感染、积液、骨水泥毒性反应等情况发生;肢体全部恢复日常活动功能,均无骨水泥及髓内钉松动断裂,骨水泥假体表面有大量骨痂生长。按Enneking肌肉骨骼系统肿瘤外科治疗重建术后功能评定标准:优3例,良1例,可1例。肢体疼痛消失4例,疼痛减轻1例。小细胞性肺癌患者死亡1例,肿瘤病灶局部轻度复发1例。结论骨水泥塑形模具改进了骨水泥充填效果,塑形更好,更坚固,无需保留瘤壳,肿瘤局部复发率和感染率更低,成本低廉,制作简便。Objective To investigate the effect of repair of the segmental femoral bone defect in limb salvage treatment with the self-made bone cement infusion tubiform bone moulding. Methods Self-made bone cement infusion tubiform bone moulding was used in the treatment of the large femoral bone defect in 5 patients. With 3 aseptic plastic syringes, the first remained 3/4 diameter was placed in the bone defect as main part, the second remained 1/2 diameter was used as barrelhead and bored a hole, and the last one full of the bone cement was made as pressed moulding. Results 5 cases were followed up for 18 -54 months. All patients got primary healing. No infection or cement toxic reaction was found. The limb functions recovered for daily routines. There was no loosening or breakage of internal fixation. The function was evaluated by Enneking System ： 3 cases were excellent, 1 good, and 1 fair. The pain were disappeared in 4 cases,and was eased in 1 case. 1 case died due to the small cell lung cancer, 1 case underwent amputation due to local recurrence. Conclusions Bone cement infusion tubiform moulding can make cement placement much more effectively and steadily ,with lower recurrence and infection rate ,which can be safely used for repair of bone defect.

关 键 词：骨水泥 骨缺损 骨肿瘤 管状骨 模具 

分 类 号：R738.1[医药卫生—肿瘤] R687.3[医药卫生—临床医学]