Mid-term radiological and functional results of biological reconstructions of extremity-located bone sarcomas in children and young adults
Mid-term radiological and functional results of biological reconstructions of extremity-located bone sarcomas in children and young adults
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DOI：
10.1097/bpb.0000000000000189
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发表时间：
2015-09-01
影响因子：
1.1
通讯作者：
Tetik, Cihangir
中科院分区：
文献类型：
--
作者：
Erol, Bulent;Basci, Onur;Tetik, Cihangir
生物重建是儿童骨肉瘤切除后重建的一种有用的选择。本研究介绍了儿童骨肉瘤切除后生物重建的中期功能和影像学结果。18例原发性长骨肉瘤患者[平均年龄12.5岁（范围4-22岁）]接受了广泛的手术切除和生物重建。骨缺损行椎间重建（n=14）、骨关节重建（n=3）和带血管腓骨移植（VFG）关节融合术（n=1）。在7例下肢重建中，VFG与大块同种异体移植物相结合。平均随访45.7个月（范围25-78个月）。12个月时，18例患者中有17例（94.4%）观察到移植物愈合和移植物肥大。24个月时，VFG-同种异体移植物骨整合率为100%。下肢和上肢重建的平均最终随访肌肉骨骼肿瘤协会（MSTS）评分分别为79.7%（范围66.6-90%）和80.9%（范围53.3-100%）。4例（22.2%）并发症需要再次手术，包括骨不连（n=1）、植入物失效（n=1）、感染（n=1）和皮肤坏死（n=1）。3例（16.6%）患者复发。缺损大小和VFG长度与MSTS评分和影像学参数无相关性（P>0.05）。使用VFG进行生物重建可提供永久稳定性，并逐渐增加功能和放射学结果。版权所有（C）2015威科医疗集团All rights reserved.
Biological reconstruction is a useful option for reconstruction following bone sarcoma resection in children. The mid-term functional and radiological outcomes of biological reconstructions after resection of bone sarcomas in children are presented in this study. Eighteen patients [average age 12.5 years (range 4-22 years)] with primary sarcomas of long bones underwent wide surgical resection and biological reconstruction. The bone defects were managed by intercalary (n=14), osteoarticular (n=3) reconstructions and arthrodesis (n=1) with a vascularized fibular graft (VFG). VFG was combined with a massive allograft in seven lower extremity reconstructions. The average follow-up was 45.7 months (range 25-78 months). Graft union and graft hypertrophy was observed in 17 (94.4%) of 18 patients at 12 months. The VFG-allograft osteointegration rate was 100% at 24 months. The average final follow-up Musculoskeletal Tumor Society (MSTS) scores for lower and upper extremity reconstructions were 79.7% (range 66.6-90%) and 80.9% (range 53.3-100%), respectively. Four (22.2%) complications, including nonunion (n=1), implant failure (n=1), infection (n=1) and skin necrosis (n=1), required reoperation. The disease relapsed in three (16.6%) patients. Defect size and VFG length did not correlate with MSTS scores and radiological parameters (P>0.05). Biological reconstruction with VFG can provide permanent stability and progressively increasing functional and radiological results. Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.