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Vascularized Fibula Grafts for Reconstruction of Bone Defects after Resection of Bone Sarcomas

机译:血管化腓骨移植修复骨肉瘤切除后的骨缺损

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摘要

We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1–24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4/3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing's sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26–75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis (n = 2), and hip dislocation (n = 1). Limb-sparing surgery with reconstruction of bone defects using vascularized fibular grafts in BS cases is feasible with acceptable clinical results, but fractures should be expected in many patients.
机译:我们评估了连续8例骨肉瘤(BS)患者(保留平均年龄13.6岁(范围4.1–24.2岁),女性/男性= 6/2)的保肢手术和使用血管化腓骨移植修复骨缺损的结果)(骨肉瘤/尤文氏肉瘤/软骨肉瘤= 4/3/1)以2000年至2006年的形式进行手术。重建的骨缺损为股骨近端和骨epi(n = 2),肱骨骨干(n = 2),肱骨近端骨physi和骨physi(n = 1),股骨干(n = 1),尺骨骨干(n = 1)和胫骨骨干(n = 1)。一名尤因氏肉瘤患者早期髋关节脱臼,发生多处转移,并在手术后9个月死亡。其余患者(n = 7)在手术后均存活50个月(26-75个月)。在随访过程中,观察到以下主要并发症:1-2处骨折(n = 4),假关节(n = 2)和髋关节脱位(n = 1)。在BS病例中使用保留血管的腓骨移植物修复保留肢体的保肢手术是可行的,并且临床结果可以接受,但是许多患者应该预期骨折。

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