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目的探讨自体近端腓骨移植重建在桡骨远端骨巨细胞瘤临床治疗中的应用及效果。方法对4例桡骨远端骨巨细胞瘤复发患者在行桡骨远端瘤段切除的同时,行自体近端腓骨移植重建手术。结果患者随访27～50个月,疼痛症状消失,骨愈合时间5～9个月,平均6.5个月,无移植骨吸收和骨折,腕关节功能握持力为对侧手的55%(40%～80%),背伸活动度可达对侧50%(10%～80%),掌屈达40%(15%～70%),无神经血管损伤症状,恢复正常工作劳动。所有患者均未出现骨巨细胞瘤的复发及肺转移。结论桡骨远端骨巨细胞瘤经广泛切除后,用自体近端腓骨移植进行保肢治疗,可较好地保留腕关节功能,是一种有效的治疗方法。
Objective To investigate the application and effect of autologous proximal fibular graft reconstruction in the treatment of giant cell tumor of distal radius. Methods Four patients with recurrent giant cell tumor of the distal radius underwent resection of the proximal fibula at the same time as the resection of the distal radius segment. Results The patients were followed up for 27 to 50 months and their symptoms disappeared. The healing time ranged from 5 to 9 months (average 6.5 months). There was no graft graft or fracture. The wrist joint function holding power was 55% (40% ~ 80%), dorsiflexion activity of up to 50% (10% ~ 80%) contralateral and 40% (15% ~ 70%) of palpable flexion, no symptoms of neurovascular injury and return to normal working labor. All patients had no recurrence of giant cell tumor of bone and lung metastasis. Conclusion After extensive resection of the giant cell tumor of distal radius, limb salvage treatment with autologous proximal fibula transplantation can well preserve the function of the wrist and is an effective treatment.