The non-vascularised fibular graft A SIMPLE AND SUCCESSFUL METHOD OF RECONSTRUCTION OF THE PELVIC RING AFTER INTERNAL HEMIPELVECTOMY
The non-vascularised fibular graft A SIMPLE AND SUCCESSFUL METHOD OF RECONSTRUCTION OF THE PELVIC RING AFTER INTERNAL HEMIPELVECTOMY
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DOI：
10.1302/0301-620x.92b7.23497
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发表时间：
2010-07-01
影响因子：
--
通讯作者：
Choong, P. F. M.
中科院分区：
文献类型：
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作者：
Akiyama, T.;Clark, J. C. M.;Choong, P. F. M.
半骨盆内切除术是骨盆恶性肿瘤的标准治疗方法。与其他技术相比，使用无血管腓骨移植物进行重建相对简单。我们描述了 1996 年至 2009 年间接受半骨盆内切除术（I 型或 I/IV 型）并通过无血管腓骨移植重建的一系列 10 名患者的手术和功能结果。该手术的一个关键先决条件是保留坐骨切迹，并在术前通过 MRI 进行了确认。所有采用单个腓骨移植物的患者都实现了移植物与宿主的结合，并且在 使用了两个移植物的下部移植物。平均愈合时间为 7.3 个月（3 至 12 个月）。在使用两个移植物的六例中，有四例上部移植物未愈合。七名患者最终能够不用拐杖行走。术后平均肌肉骨骼肿瘤协会评分为 75.4%（16.7 至 96.7）。无术后深部感染病例。平均骨盆缩短为 0.9 厘米（0.2 至 3.4）。 3 例肿瘤复发，1 例因肿瘤相关疾病死亡。需要半骨盆内切除术的患者，如果用无血管腓骨移植物重建骨盆环，效果会很好。并发症发生率低，并且获得了良好的功能结果。
Internal hemipelvectomy is a standard treatment for malignant tumours of the pelvis. Reconstruction using a non-vascularised fibular graft is relatively straightforward compared to other techniques. We describe the surgical and functional outcomes for a series of ten patients who underwent an internal hemipelvectomy (type I or I/IV) with reconstruction by a non-vascularised fibular graft between 1996 and 2009. A key prerequisite for this procedure was a preserved sciatic notch, confirmed pre-operatively on MRI.Graft-host union was achieved in all patients with a single fibular graft, and in the lower graft where two grafts had been used. The mean time to union was 7.3 months (3 to 12). The upper graft did not unite in four of six cases where two grafts had been used. Seven patients were eventually able to walk without a stick. The mean post-operative Musculoskeletal Tumour Society score was 75.4% (16.7 to 96.7). There were no cases of deep post-operative infection. The mean pelvic shortening was 0.9 cm (0.2 to 3.4). Recurrent tumour occurred in three cases, and death from tumour-related disease occured in one.Patients who need an internal hemipelvectomy will do well if their pelvic ring is reconstructed with a non-vascularised fibular graft. The complication rate is low, and they attain a good functional outcome.