Allograft reconstruction for bone sarcoma of the tibia in the growing child
Allograft reconstruction for bone sarcoma of the tibia in the growing child
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DOI：
10.1302/0301-620x.88b1.16253
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发表时间：
2006-01-01
影响因子：
--
通讯作者：
Exner, GU
中科院分区：
文献类型：
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作者：
Ramseier, LE;Malinin, TI;Exner, GU
肿瘤切除后胫骨同种异体移植物重建的结果不一致，失败率高。在生长板开放的儿童中使用胫骨同种异体移植物的报道很少。我们对19名7至17岁的连续患者进行了21次同种异体移植重建（16次骨关节重建，5次椎间重建）。其中2例为尤文氏肉瘤，1例为造釉细胞瘤，16例为骨肉瘤，1例为多灶性病变，5例死亡，14例随访时无疾病。6例存活患者（8例同种异体移植重建）在平均59个月（14至132个月）时继续保持良好或极好的功能。1例患者在31个月时功能较差。其他7名患者在平均101个月（43 - 198）时接受了包括同种异体移植物交换和表面置换或内假体翻修在内的额外手术后功能良好或极好。在第一次重建后平均47个月（20 ~ 84个月）进行额外的手术。在生长发育的儿童中使用同种异体移植物重建，关节和生长板至少可以部分保留。虽然我们的结果仍然不一致，但在选定的患者中，胫骨同种异体移植物重建可以恢复肢体完整和持久的功能。
The outcome of tibial allograft reconstruction after resection of a tumour is inconsistent and has a high rate of failure. There are few reports on the use of tibial allografts in children with open growth plates. We performed 21 allograft reconstructions (16 osteoarticular, five intercalary) in 19 consecutive patients between seven and 17 years of age. Two had Ewing's sarcoma, one an adamantinoma and 16 osteosarcoma, one with multifocal disease.Five patients have died; the other 14 were free from disease at the time of follow-up. Six surviving patients (eight allograft reconstructions) continue to have good or excellent function at a mean of 59 months (14 to 132). One patient has poor function at 31 months. The other seven patients have a good or excellent function after additional procedures including exchange of the allograft and resurfacing or revision to an endoprosthesis at a mean of 101 months (43 to 198). The additional operations were performed at a mean of 47 months (20 to 84) after the first reconstruction.With the use of allograft reconstruction in growing children, joints and growth plates may be preserved, at least partially. Although our results remain inconsistent, tibial allograft reconstruction in selected patients may restore complete and durable function of the limb.