冷冻异体半关节移植治疗四肢骨巨细胞瘤  

Massive Allograft Bones Implantation for Defects after GCT Resections

作　　者：纪方[1] 孙庆斌[1] 陈舰[1] 蔡郑东[1] 顾雄华[1] 刘植珊[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国矫形外科杂志》2001年第10期970-972,共3页Orthopedic Journal of China

摘　　要：目的 :探讨分析冷冻大段同种异体骨关节移植治疗骨肿瘤的临床应用及疗效。方法 :回顾分析 1991～1999年间 ,应用冷冻保存大段同种异体骨关节治疗骨肿瘤切除后遗留大块骨缺损。就随访资料完整 ,且随访时间超过 1年的 48例进行临床分析。 48例中男 2 8例 ,女 2 0例 ,年龄 18～ 46岁 ,平均 34.5岁 ,初发骨巨细胞瘤 36例 ,复发骨巨细胞瘤 12例 ,异体骨移植长度 8～ 2 0cm。普通髓内钉固定 16例 ,交锁髓内钉固定 13例 ,螺栓固定 19例。结果 :48例患者得到随访 ,平均随访时间 4.5年 ( 2～ 9年 ) ,结果异体骨愈合 47例 ,不愈合 1例 ,主要并发症 :感染 2例 ,骨折 2例 ,关节面塌陷关节强直 2例 ,关节功能按Mankin标准评定 ,本组优 18例 ,良 2 3例 ,中 4例 ,差 3例 ,治疗满意率 93.7%。结论 :冷冻大段同种异体骨关节移植是修复骨巨细胞瘤切除后骨缺损的有效手段 。Objective: To report the results of large segment allografts in the treatment for giant cell tumor. Methods: A retrospective analysis of 48 consecutive cases of large segment allograft implantations after resection of bone tumors from 1991 to 1999 was conducted. The allogeneic bone healing were observed. 48 cases had an average age of 34.5 years (ranged 18～46 years). 36 to 48 cases aggressive giant cell tumor of bone, 12 of 48 cases recurrence tumors. The mean length of allograft was 14.5cm (ranged 8～20cm). The types of fixation included common intramedullary nailing in 16 cases, inter locking intramedullary nailing in 13 cases, screw cork 19 cases. Results:Following up period ranged from l year to 9 years(average 4.5 years) in 48 cases. 47 cases had union and 1 non union. The major complications were infection 2 cases, fracture 2 cases, absorption and collapse of articular surface 3 cases. The patients were evaluated in regard to function with use of Mankin system. 18 cases had excellent results, 23 cases good, 4 cases fair. satisfactory rate 93.7%. Conclusion: The allograft bones implantation is a most desirable graft material for repair of bone defected in course of limb salvage following resections of GCT. Satisfactory results were obtained with the indication controled.

关 键 词：骨肿瘤 骨移植 同种异体 手术 治疗结果 骨缺损 冷冻 

分 类 号：R738.1[医药卫生—肿瘤]