特制人工假体在胫骨近端骨肉瘤保肢手术中的应用  

Application of custom prosthesis replacement in proximal tibia osteosarcoma salvage surgery

作　　者：韩纲[1] 毕文志[1] 贾金鹏[1] 王威[1] 许猛[1] 

机构地区：[1]解放军总医院海南分院骨科,海南三亚572013

出　　处：《解放军医学院学报》2014年第4期329-331,337,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨特制人工假体在胫骨近端骨肉瘤保肢手术的临床疗效。方法对我院2005年9月-2008年6月胫骨近端ⅡB期骨肉瘤经新辅助化疗后行特制人工关节手术患者进行回顾性随访分析。共26例，其中男12例，女14例。年龄11。47岁，平均18．7岁。瘤段长度10～18em，平均14．4cm。同时累及腓骨近端4例。结果随访60。93个月，平均80．3月。2例（7．7％）术后复发，7例死于肿瘤转移，5年无瘤生存率73．1％。关节感染3例，占11．5％。1例腓总神经不完全损伤。膝关节伸膝延迟平均5°（0°～20°）。骨骼肌肉系统肿瘤术后重建功能评估系统评分22。30分，平均25．5分。结论特制人工假体治疗胫骨近端骨肉瘤存在诸多并发症，但其具有早期可靠的稳定性，中长期较好的肢体功能，是胫骨近端骨肉瘤重要的保肢手术方式。Objective To study the application of custom prosthesis replacement in proximal tibia osteosarcoma salvage surgery. Methods Twenty-six patients （12 males and 14 females） aged 11-47 years （mean 18.7 years） admitted to our hospital from September 2005 to June 2008 who underwent joint prosthesis replacement for proximal tibia II B osteosarcoma after chemotherapy were retrospectively analyzed. The tumor was 10-18 cm long （mean 14.4 cm）. The proximal fibula was involved in 4 out of the 26 patients. Results The patients were followed up for 60-93 months （mean 80.3 months）, during which 2 patients （7.7%） had relapse of the tumor after operation and 7 patients died of tumor metastasis with a 5-year disease free survival rate of 73.1%. Joint infection occurred in 3 patients （11.5%） and incomplete common peroneal nerve injury occurred in 1 patient. The average knee extension was delayed 5° （0°-20°）. The musculoskeletal tumor society （MSTS） score of knee was 22-30 （mean 25.5）. Conclusion Custom prosthetic replacement is an important limb salvage procedure for proximal tibia osteosarcoma with an early reliable stability and a mid- and long-term effect, although it results in a number of complications.

关 键 词：骨肉瘤 胫骨 关节成形术 

分 类 号：R738.1[医药卫生—肿瘤]