摘要
胫骨下段肿瘤的周围软组织覆盖量有限,生物力学复杂,使得肿瘤切除重建较为困难。人工假体可为胫骨下段肿瘤切除后骨缺损提供良好的机械强度,但术后并发症较多,且需解决软组织覆盖不足及术后踝关节不稳定等问题。三维数字技术的发展为胫骨中下段重建提供了新的治疗策略,相比早期的踝关节保留型假体,三维打印融合型假体的快速骨整合效应提供了较好的踝关节稳定性及肢体功能。此外,三维打印假体可通过个性化设计缩小假体周径,及与距骨进行适形匹配等减少软组织覆盖不足及距骨塌陷等并发症。目前胫骨下段假体的相关研究报道较少,三维打印融合型假体的安全性需大量长期随访研究结果验证,假体近端及远端固定方式的选择方法需在未来研究中探索。
The limited coverage of soft tissue and complex biomechanical factors make resection and reconstruction of distal tibial tumors extremely challenging.Megaprosthesis can provide good mechanical strength for tumor en bloc resection,but there are many postoperative complications,and the problems of insufficient soft tissue coverage and postoperative ankle instability must be solved.The development of three-dimensional digital technology may provide a new treatment strategy for distal tibial reconstruction.Compared to ankle joint preservation endoprostheses,the rapid osseointegration effect of three dimensional-printed megaprosthesis with ankle arthrodesis provides better ankle joint stability and postoperative function.In addition,the three dimensional-printed megaprosthesis may improve complications such as insufficient soft tissue coverage and talus collapse by reducing the circumference of the prosthesis and matching it with the talus through personalized design.Of course,there are few research reports on distal tibial prostheses,and the safety of three dimensional-printed megaprosthesis with ankle arthrodesis needs to be confirmed through extensive long-term follow-up studies.The selection of proximal and distal fixation methods for prostheses needs to be explored in future research.
作者
向海滨
艾克拜尔·尤努斯
田征
陈江涛
亚地坎·亚生江
Xiang Haibin;Yunus Akbar;Tian Zheng;Chen Jiangtao;Yadikan Yashengjiang(Department of Bone Tumor,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2023年第12期1130-1134,共5页
Chinese Journal of Surgery
