CAJ | 학술논문

目的观察带血管腓骨头移植治疗桡骨远端骨肿瘤的临床疗效.方法自2007年6月至2010年12月,应用带血管腓骨头移植治疗桡骨远端良性复发肿瘤及恶性骨肿瘤患者6例,年龄17～ 53岁,平均32.5岁.其中3例患者为多次手术后复发.患者均知情同意后,行肿瘤En-bolc 切除,采用带血管腓骨头移植重建骨缺损及桡腕关节,同时行内固定术,移植腓骨长度为11～ 16 cm.结果 6例患者均获得随访,随访时间6个月至3年,平均19个月.手术切口Ⅰ期愈合,无感染发生,移植腓骨均获骨性愈合,部分患者已行内固定取出.Mayo腕关节功能评分为55～90分,平均82分.Gartland-Werley腕关节功能评分:优1例,良4例,中1例；优良率83.3％.结论带血管腓骨头移植用于修复桡骨远端肿瘤性骨缺损是可行的,尤其是对于桡腕关节的骨支架支撑重建具有其独特的优点,但仍需积累更多病例及更长期的随访,以观察远期效果.
목적 관찰대혈관비골두이식치료뇨골원단골종류적림상료효.방법 자2007년6월지2010년12월,응용대혈관비골두이식치료뇨골원단량성복발종류급악성골종류환자6례,년령17～ 53세,평균32.5세.기중3례환자위다차수술후복발.환자균지정동의후,행종류En-bolc 절제,채용대혈관비골두이식중건골결손급뇨완관절,동시행내고정술,이식비골장도위11～ 16 cm.결과 6례환자균획득수방,수방시간6개월지3년,평균19개월.수술절구Ⅰ기유합,무감염발생,이식비골균획골성유합,부분환자이행내고정취출.Mayo완관절공능평분위55～90분,평균82분.Gartland-Werley완관절공능평분:우1례,량4례,중1례；우량솔83.3％.결론 대혈관비골두이식용우수복뇨골원단종류성골결손시가행적,우기시대우뇨완관절적골지가지탱중건구유기독특적우점,단잉수적루경다병례급경장기적수방,이관찰원기효과.
Objective To evaluate the clinical outcomes of autologous vascularized fibular head transfer for repair of distal radius bone defects caused by bone tumor.Methods From June 2007 to December 2010 vascularized fibular head transfer was used in the treatment of distal radius bone defect caused by resection of benign recurrent tumors and malignant bone tumors in 6 patients.Patient ages were 17 to 53 years,with a mean of 32.5 years.Three patients had multiple tumor recurrence.After informed consent was obtained,tumor Enbolc excision was carried out.The bone defect and wrist joint surface was repaired using vascularized fibular head transfer with intemal fixation.The transplanted fibula was 11 to 16 cm in length.Results All 6 patients were follow-up for6 months to 3 years,with an average of 19 months.Primary wound healing was aclieved in all cases without infection.Healing and integration of the transplanted fibular head was observed and internal fixation removed in some patients.Mayo wrist score averaged 82,ranging from 55 to 90.By the Gartland-Werley standard score,the wrist function was rated as excellent in 1 case,good in 4 cases and fair in 1 case,with an excellent to good rate of 83.3 ％.Conclusion Vascularized fibular head transplantation used to repair distal radius bone defects after tumor resection is feasible.It has unique advantage in retaining wrist joint support by restoring the bone frame.More cases and longer follow-up are required to evaluate the long-term effects.