下肢恶性骨肿瘤切除假体置换的软组织重建

目的 研究下肢恶性骨肿瘤切除、人工假体置换后软组织重建的方法和效果。方法 为32例接受瘤段切除、人工假体置换保肢手术的下肢恶性骨肿瘤患者施行各种形式的软组织重建手术。其中病变位于近侧股骨、远侧股骨、近侧胫骨者分别为6例、19例和7例；骨肉瘤28例，软骨肉瘤3例，恶性纤维组织细胞瘤1例。根据病变所在不同部位施行不同形式的软组织重建。结果 32例平均随访36．2个月（22-40个月）。3例局部复发，4例死亡。参照Enneking评分标准，28例关节功能优良。结论 正确的软组织重建手术，保证了关节功能，减少了肿瘤局部复发和切口并发症。软组织重建手术在下肢恶性骨肿瘤切除、假体置换后具有重要意义。

Soft tissue reconstructions in prosthesis replacement after sarcomas resection of the lower etremity

Objective To study the clinical effects of soft tissue reconstructions in limb-sparing pros- thetic replacement for sarcomas of the lower extremity.Methods limb-sparing surgery with prothesis replacement were performed in 32 patients with sarcomas of the lower extremity and there were 6 cases in proximal femur and 19 cases in distal femur and 7 cases in proximal tibia.There were 28 osteosar- comas and 3 chondrosarcomas and one MFH.Different types of soft tissue reconstructions were used according to the anatomy site.Results Thirty-two patients were followed up for 22-40 months(aver- aged 36.2 months).There were 3 cases with local recurrence and 4 patients dead of disease.The function were assessed by Enneking system and 28 patients were rating for good and excellent.Conclu- sions It is important to reconstruct the soft tissues in treatment of sarcomas of lower extremity.