來源資料
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題 名 | Endoprosthetic Reconstruction for Limb Salvage Surgery |
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作 者 | Yang,Rong-sen; |
書刊名 | 醫學工程 |
卷 期 | 10:1 1998.02[民87.02] |
頁 次 | 頁23-34 |
分類號 | 416.26 |
關鍵詞 | 肢體保留技術; 骨腫瘤; Bone tumor; Endoprosthesis; Limb salvage; Endoprosthetic reconstruction; |
語 文 | 英文(English) |
英文摘要 | In the recent two decades, the advent of adjuvant chemotherapy for osteosarcoma reduces the lung metastasis rate and improves the patient's survival. The advance of adjuvant chemotherapy also permits a closer surgical resection margin which makes the limb salvage procedure feasible for treatment of malignant bone tumor of extremity. The object of the limb salvage surgery is to widely resect the local tumor and, at the same time, to preserve a well-functioning, tumor-free, and painless limb. A successful limb salvage procedure can improve body balance, simplify the rehabilitation process and preserve intact body image. The overall functional results improve much, as compared to those patients with amputees. Up to the present the local recurrence and survival outcomes of wide resection of osteosarcoma in the extremity followed by limb reconstruction is well-selected patients is as good as those treated by amputation and chemotherapy. At the present the indications of such a limb salvage procedure have been expanded to treat other malignant bone tumor as well as some nonmalignant tumorous conditions of the extremity, such as aggressive benign bone tumors. A variety of limb reconstruction options are available, including resection arthrodesis, various bone grafting technique (autograft, allograft, or allograft/endoprosthesis composite), endoprosthesis reconstruction, llizarov leg lengthening, and rotationplasty for some cases. Each limb salvage protocol has its own advantages and drawbacks. The decision of any limb salvage procedure must be made on the basis of careful radiological staging, pathological staging and clinical status. Among them custom-made metallic endoprosthesis is a good reconstruction option which can permit immediate rehabilitation program and provide a durable and functional limb. With the refinement of the material and design, the careful selection and application of custom made endoprosthesis will provide a successful limb reconstruction for patients with malignant bone tumors, some aggressive or multiply recurrent benign bone tumors as well as other special conditions. |