股骨Z型截骨旋转上移异体骨移植治疗骨盆肿瘤切除后骨缺损  

Femoral Z osteotomy and rotation hip transposition with allograft for defect after pelvic tumor resection

作　　者：徐海荣[1] 李远[1] 鱼锋[1] 牛晓辉[1] XU Hai-rong;LI Yuan;YU Feng;NIU Xiao-hui(Department of Orthopaedic Oncology Surgery,Beijing Ji Shui Tan Hospital,Beijing,100035,China)

机构地区：[1]北京积水潭医院骨肿瘤科,100035

出　　处：《中国骨与关节杂志》2022年第5期333-338,共6页Chinese Journal of Bone and Joint

基　　金：希思科-石药肿瘤研究基金(Y-SY201902-0057)。

摘　　要：目的评价股骨Z型截骨旋转上移异体骨移植治疗骨盆肿瘤切除后骨缺损的功能与预后。方法回顾性分析了2011年1月至2016年12月,共10例骨盆肿瘤患者接受股骨Z型截骨旋转上移异体骨移植。其中3例在2年内死亡,其余7例随访99.6个月,平均63.3~123.8个月。评估所有患者并发症的发生情况。评估存活患者的MSTS功能评分、髂股关节融合与假关节情况、双下肢长度差异。结果10例中4例出现手术相关并发症,其中2例发生深部感染,再次手术后痊愈,另2例非手术治疗痊愈。7例存活患者MSTS评分的中位数为20分(17~30分)。7例存活患者中,4例髂股关节获得骨融合,其余3例发生假关节。7例存活患者术后即刻双下肢长度差异中位数为7(2~15)mm,最后一次随访中位数为12(1~19)mm,差异无统计学意义。结论股骨Z型截骨旋转上移异体骨移植术治疗骨盆肿瘤切除后骨缺损的长期功能和并发症可以接受,值得进一步临床研究。Objective Reconstruction of bone defects after resection of pelvic tumors,especially those around the acetabulum,is challenging.The aim of this study is to evaluate the long-term functional outcome of femoral Z osteotomy and rotation hip transposition with allograft.Methods From January 2011 to December 2016,a total of10 patients with pelvic tumors underwent femoral Z osteotomy and rotation hip transposition with allograft.Three patients died within 2 years,and the average follow-up time of the remaining 7 patients was 99.6 months(range:63.3-123.8 months).Complications were assessed in all patients.MSTS score,iliofemoral arthrodesis and pseudarthrosis,and lower limb discrepancy were evaluated in the survivors.Results Four of 10 patients had surgery-related complications.Two had deep infection and recovered after reoperation.The other 2 patients recovered after non-surgery treatment.The median MSTS score for 7 survivors was 20(range:17-30).Bone fusion was achieved at the iliofemoral joint in 4 out of 7 survivors.The other 3 patients developed pseudarthrosis.The median lower limb discrepancy was 7 mm(range:2-15 mm)immediately after surgery and 12 mm(range:1-19 mm)at the latest follow-up.Differences were not statistically significant.Conclusions The long-term function and complication of femoral Z osteotomy and rotation hip transposition with allograft are acceptable and worthy of further clinical study in the treatment of bone defect after resection of pelvic tumor.

关 键 词：骨肿瘤 骨盆 骨移植 移植 同种 修复外科手术 

分 类 号：R738.1[医药卫生—肿瘤]