大段同种异体半关节移植远期疗效分析  

Long-term Observation On Massive Allograft Bones Implantation for Defects

作　　者：纪方[1] 刘植珊[1] 孙庆斌[1] 蔡郑东[1] 陈舰[1] 顾雄华[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》2002年第8期733-735,共3页Orthopedic Journal of China

摘　　要：目的 :探讨分析同种异体半关节移植的临床应用及远期疗效。方法 :回顾分析应用同种异体半关节移植治疗近关节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 5年的 70例进行临床分析。异体骨移植长度 8～ 2 5cm。普通髓内钉固定 2 5例 ,交锁髓内钉固定 2 1例 ,螺栓固定 2 2例 ,钢板固定 2例。结果 :70例患者得到随访 ,平均随访时间 10 .5年 (5～ 2 2年 )。异体骨愈合 68例 ,不愈合 2例。主要并发症 :肿瘤局部复发 8例 ,感染 7例 ,骨折 3例 ,关节面塌陷 6例 ,关节强直 2例。关节功能按Mankin标准评定 :优 2 3例 ,良 19例 ,中 12例 ;满意率 78.2 %。结论 :同种异体半关节移植是修复骨肿瘤切除后骨缺损的有效手段 ,但应严格掌握其适应证。Objective: To report the long term observation of large segment allografts in the treatment for bone tumor. Methods: A retrospective analysis of 70 consecutive cases of large segment allograft implantations after resection of bone tumor was conducted. The allogeneic bone healing were observed. Seventy cases had an average age of 38.4 years(ranged 14～71 years). There were 8 osteosarcomas, 45 aggressive giant cell tumor of bone, 17 other bone tumors. The mean length of allograft was 15.5cm(ranged 8～25cm). The types of fixation included common intramedullary nailing in 25 cases, inter locking intramedullary nailing in 21 cases, plate in 2 cases, screw in 22 cases. Results: Following up period ranged from 5 years to 22 years(averaged 10.5 years) in 70 cases. 68 cases had union and 2 non unions. The major complications were recurrence in 8 cases, infection 7 cases, fracture 3 cases, absorption and collapse of articular surface 6 cases. The patients were evaluated in regard to function with use of Mankin system. 23 cases had excellent results,19 cases good, 12 cases fair. Satisfactory rate was 78.2%. Conclusion: The allograft bones implantation is the most desirable graft material for repair of bone defected in course of limb salvage following resections of bone tumor. Satisfactory results can be obtained with the indication controlled.

关 键 词：疗效 骨肿瘤 骨移植 同种异体 治疗 骨缺损 半关节移植 

分 类 号：R687.4[医药卫生—骨科学]