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以成骨肉瘤为代表的骨恶性肿瘤,由于病因学研究的困扰,长期以来以早期高位截肢来挽救生命,但结果多不满意,5年存活率仅维持在20％左右。70年代以来由于Rosen首先提出新辅助化疗法配合手术治疗,并发现应用新化疗后无论采取早期截肢或瘤段切除保留肢体,其生存率是相同的,且五年存活率由以前的20％提高到80％,这一变化,鼓舞了外科工作者对保肢技术产生新的兴趣。我们1993年以来对病变局限的下肢恶性骨肿瘤采取局部瘤段整块切除,并用多平面半环架一期加压融合瘤段切除后的上下骨端,为了补救瘤段切除后的下肢短缩,我们同期行胫骨干骺端骨延长术,如此在早期治疗时,充分考虑到肢体的功能修复重建,以提高患者的生活质量,收到了满意的效果。
Osteoblastomas represented by osteosarcoma are plagued by etiological studies and long-term amputation has been used to save lives. However, the results are mostly unsatisfactory. The 5-year survival rate is only maintained at about 20%. Rosen first proposed neoadjuvant chemotherapy combined with surgical treatment since the 1970s, and found that the survival rate is the same regardless of early amputation or tumor resection after new chemotherapy is applied, and the five-year survival rate has been increased from the previous 20%. By 80%, this change has inspired surgeons to generate new interest in limb salvage technology. Since 1993, we have taken a local resection of the malignant bone tumor of the lower extremity with localized lesions. We have used a multi-planer half ring for the compression of the upper and lower bone ends after resection of the tumor, in order to rescue the shortened lower extremity after resection of the tumor segment. In the same period of time, we performed the humerus metaphysis bone lengthening. In the early treatment, we fully considered the functional reconstruction of the limbs to improve the quality of life of the patients and received satisfactory results.