Extracorporeally frozen tumour-bearing bone combined with free vascularised fibula for the intercalary reconstruction of femoral defect after resection of bony sarcoma
Extracorporeally frozen tumour-bearing bone combined with free vascularised fibula for the intercalary reconstruction of femoral defect after resection of bony sarcoma
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DOI：
10.1016/j.bjps.2016.02.018
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发表时间：
2016-06-01
影响因子：
2.7
通讯作者：
Ji, Chuanlei
中科院分区：
文献类型：
--
作者：
Li, Jing;Zhang, Fujun;Ji, Chuanlei
背景：随着骨肉瘤患者生存率的提高，利用生物技术重建股骨骨间缺损成为一种趋势。本研究考察了带血管化腓骨的冷冻自体股骨移植物在功能结果和并发症方面是否与其他重建选择相媲美。材料和方法：2008年至2012年间，8例股骨骨肉瘤患者接受了自体冷冻再循环移植物与内部带血管的腓骨瓣的重建。回顾性分析肿瘤和功能结果。结果：平均随访48.7个月（37 ~ 71）。5例患者肿瘤结果连续无病；其中一人没有患病的证据，一个病人带病活着，另一个死于疾病。缺损平均长度为13.6 cm（9-21）。所有病例均实现骨愈合。平均骨愈合时间为7.9个月（5-19），完全负重时间为7.8个月（6-11）。本组病例均无感染或构造性骨折。观察到2例并发症。1例软组织肿瘤复发行肿瘤切除治疗。一例胫骨骨折用石膏固定成功处理。肌肉骨骼肿瘤协会的平均功能评分为95%（27-30）。所有患者的结构都完好无损。结论：带血管的腓骨皮瓣联合冷冻自体移植物是股骨肉瘤切除术后大面积骨缺损重建的可靠和持久的选择。它具有骨愈合可靠、并发症少的优点，与其他生物重建相比较。治疗性研究证据评定量表四级，治疗性研究。(C) 2016年由Elsevier Ltd代表英国整形、重建和美容外科医生协会出版。
Background: With the improved survival for patients with bone sarcomas, there is a trend to reconstruct intercalary femur defects using biologic techniques. This study examined whether the results of a frozen femur autograft with vascularised fibula are comparable to other reconstructive options in terms of the functional outcomes and the complications.Materials and methods: Between 2008 and 2012, eight patients with bony sarcoma of the femur were subjected to reconstruction with a recycled frozen autograft combined with a vascularised fibula flap inside. The oncologic and functional results were analysed retrospectively.Results: The mean follow-up was 48.7 months (37-71). The oncologic results were continuously disease free in five patients; there was no evidence of disease in one, one patient was alive with disease and another died of the disease. The average length of defect was 13.6 cm (9-21). Bone union was achieved in all cases. The mean time to bone union was 7.9 months (5-19) and to full weight bearing was 7.8 months (6-11). There was no infection or construct fracture in this series. Two complications were observed. One tumour recurrence in soft tissue was treated with reresection. One tibia fracture was successfully managed with cast immobilisation. The average Musculoskeletal Tumor Society functional score was 95% (27-30). The construct was intact in all patients.Conclusions: Vascularised fibular flap combined with frozen autografts is a dependable and durable option for the reconstruction of large bony defects after femoral sarcoma resection. It had the merits of reliable bone union and low complications, which compare well with other biological reconstructions. Evidence Rating Scale for Therapeutic Studies Level IV, therapeutic study. (C) 2016 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.