摘要
目的探讨应用Masquelet膜诱导技术治疗肢体肿瘤切除后长节段骨缺损的疗效。方法回顾性分析2014年12月至2018年12月我院应用膜诱导技术治疗的5例骨肿瘤病人的临床资料,其中男4例,女1例,年龄为15~60岁,平均为35.8岁。病人均实施序贯性治疗方案:第1阶段彻底切除肿瘤的基础上,内固定稳定骨端和置入骨水泥间隔物;第2阶段,去除间隔物,在诱导膜内植入自体松质骨修复骨缺损。采用Ilizarov方法研究与应用协会(Association for the Study and Application of the Method of Ilizarov, ASAMI)评价标准评价综合疗效,美国肌肉骨骼肿瘤学会(Musculoskeletal Tumor Society, MSTS)评分系统评价病人功能恢复情况。结果病人骨缺损长度为8.5~11.0 cm,平均为9.5 cm。5例病人术后获10~34个月的随访,平均为15.4个月,无局部复发,无感染发生。骨愈合时间为第二阶段后4.2~11.0个月,平均为6.4个月。ASAMI评定标准均为优秀,MSTS评分平均为27.4分(25~29分)。1例出现骨质部分吸收,成骨菲薄,但功能正常。结论 Masquelet膜诱导技术治疗肿瘤切除后节段性骨缺损,是一种安全、简便、可靠的方法。
Objective To investigate the effect of Masquelet membrane induced technique in the treatment of segmental long bone defects after resection of limb tumors. Methods A retrospective analysis of the clinical data of 5 patients with bone tumors treated with membrane induced technique in our hospital from December 2014 to December 2018 was conducted, including 4 males and 1 female, aged 15 to 60 years, with an average of 35.8 years. All patients received the sequential therapy: In the first stage after complete resection of the tumor, the bone was stabilized by the internal fixation and a bone cement spacer was implanted. In the second stage, the spacer was removed and autologous cancellous bone was implanted in the induced membrane to repair the bone defect. The Association for the Study and Application of the Method of Ilizarov(ASAMI)evaluation standard was used to evaluate the comprehensive efficacy, and the American Musculoskeletal Tumor Society(MSTS) scoring system was used to evaluate the functional recovery of patients. Results The length of the bone defects was 8.5-11.0 cm(average 9.5 cm). Five patients were followed up for 10-34 months(average15.4 months) after operation, and no local recurrence or infection occurred. The time of bone healing was 4.2-11 months after the second stage, with an average of 6.4 months. The ASAMI evaluation standards were excellent,and the average MSTS score was 27.4 points(25-29 points). One case had partial bone resorption, osteoblastic thinness, but normal function. Conclusion Masquelet membrane induced technique is a safe, simple and reliable method for treating segmental bone defects after resection of limb tumors.
作者
韩天宇
纪振钢
张昊
宋夏楠
梁娜
周大鹏
HAN Tian-yu;JI Zhen-gang;ZHANG Hao;SONG Xia-nan;LIANG Na;ZHOU Da-peng(Department of Orthopaedics,General Hospital of Northern Theater Command,Shenyang 110016,China;The First Department of Leading-treating,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《骨科》
CAS
2020年第4期287-292,共6页
ORTHOPAEDICS
关键词
骨肿瘤
骨重建
节段性骨缺损
诱导膜技术
骨水泥间隔物
Bone tumor
Bone reconstruction
Segmental bone defect
Induced membrane technique
Bone cement spacer
