胫骨下段大段瘤性骨缺损修复重建的研究进展  

Progress in repair and reconstruction of large segmental bone tumor defect in distal tibia

作　　者：赵坤 王延岭[1] 卢敏勋 姚凯 肖聪[1] 周勇[1] 闵理[1] 罗翼[1] 屠重棋[1] ZHAO Kun;WANG Yanling;LU Minxun;YAO Kai;XIAO Cong;ZHOU Yong;MIN Li;LUO Yi;TU Chongqi(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China)

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国修复重建外科杂志》2018年第9期1211-1217,共7页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家重点研发计划资助项目(2016YFC1102003);四川省科技研究项目(2017SZ0095)~~

摘　　要：目的对胫骨下段大段瘤性骨缺损的修复重建方式进行综述。方法查阅国内外胫骨下段大段瘤性骨缺损重建方式的相关文献,从保留踝关节术及非保留踝关节术两方面进行总结分析。结果对于胫骨下段大段瘤性骨缺损的修复重建,除了常规的同种异体骨移植、带血管自体腓骨移植、同种异体骨复合带血管腓骨移植、瘤段灭活回植、牵张成骨及骨搬运技术外,临床已逐渐开始应用膜诱导成骨技术、人工肿瘤干假体、3D打印金属骨小梁假体、踝关节融合术、人工肿瘤踝关节置换术。另外,因胫骨下段恶性肿瘤患者生存期较长,骨缺损修复重建后的功能恢复也受到越来越多关注。结论胫骨下段大段瘤性骨缺损修复重建方式已获得长足进步,但对于最佳方式仍存在争议。随着近年来3D打印技术及各类术前模拟技术的出现,个性化、精准化修复重建胫骨下段大段瘤性骨缺损成为可能,需要进一步探讨研究。Objective To review the methods of repair and reconstruction of the large segmental bone tumor defect in distal tibia. Methods The related literature of repair and reconstruction of the large segmental bone tumor defect in disatal tibia was reviewed and analyzed in terms of the reserved ankle joint and the non-reserved ankle joint.Results For large segmental bone tumor defect in distal tibia, the conventional allograft bone transplantation,vascularized autologous fibular transplantation, vascularized fibular allograft, inactivated tumor regeneration, distraction osteogenesis, and bone transport techniques can be selected, and the membrane-induced osteogenesis, artificial tumor stem prosthesis, three-dimensional printed metal trabecular prosthesis, ankle arthrodesis, artificial tumor ankle joint placement surgery are gradually to be applied to repair the bone defect. Moreover, due to its long survival time, the function of reconstructed bone tumor defect in the distal tibia has also received increasing attention. Conclusion Although the ideal methods has not yet been developed, great progress has been achieved in repair and reconstruction of the large segmental bone tumor defect in the distal tibia. Recently, with the appearance of three-dimensional printing and various preoperative simulation techniques, personalized and precise therapy could become ture, but therapies for the large segmental bone tumor defect in the distal tibia still need to be further explored.

关 键 词：胫骨下段 大段瘤性骨缺损 修复重建 

分 类 号：R687.3[医药卫生—骨科学]