桡骨远端骨巨细胞瘤切除自体腓骨头游离移植重建桡腕关节疗效分析.docVIP

精品论文 参考文献 桡骨远端骨巨细胞瘤切除自体腓骨头游离移植重建桡腕关节疗效分析 庄　永１　陈　芒２　陈锡中１　曾凡清１　赵楚浩１ 　　１．潮州市潮汕骨伤科医院骨科　广东　潮州　５２１０００;２．潮州市１８８医院关节外科　广东　潮州　５２１０００ 　　【摘要】　目的　探讨桡骨远端骨巨细胞瘤段切除自体腓骨头游离移植重建桡腕关节功能的疗效.方法　选取２０１０年６月－２０１５年６月１１例桡骨远端骨巨细胞瘤患者为研究对象,予肿瘤切除术并取自体腓骨头移植重建桡腕关节,观察治疗前后相关指标的变化.结果　治疗后在腕关节掌屈、背伸、尺偏、桡偏上较治疗前明显提高,握力是健侧百分比也有明显提高,治疗前后在掌屈、背伸、尺偏、桡偏、握力是健侧百分比比较差异显著(P＜０．０５);总疗效上,优良率６０．８７％,总有效率为８６．９６％;治疗后在肢体疼痛上较治疗前明显下降,而在功能活动、腕关节活动度、手精细操作、抬举能力和自我感受则较治疗前明显提高,治疗前后在肢体功能评估６方面比较差异显著(p均＜０．０５);治疗后供区关节活动度平均增加(１０．２plusmn;１．６)deg;,肌力增加Ⅰ级以上４例,Ⅱ级５例,Ⅲ级及以上２例.皮肤感觉上有８例恢复良好.结论　桡骨远端骨巨细胞瘤切除自体腓骨头移植重建桡腕关节疗效显著. 【关键词】　桡骨远端骨巨细胞瘤;　腓骨头移植;　重建桡腕关节Efficacyofdistalradiusbonegiantcelltumorresectionwithautologousfibularheadgraftreconstructionwristjoint【Abstract】objective　Toinvestigateefficacyofdistalradiusbonegiantcelltumorresectionwithautologousfibularheadgraftreconstructionwristjoint．MethＧods　２３patientsofgiantcelltumorofdistalradiusfromJune２０１０－June２０１５wereselected．theyweretreatedwithtumorresection,andtheywerereconstrucＧtionofwristjointbyautologousfibularheadgraft．andchangesrelatedindicatorsofpatientbeforeandaftertreatmentwereanalysised．Results　Aftertreatment,thewristflexion,dorsiflexion,ulnardeviation,radialdeviationonthanbeforetreatmentsignificantlyimprovedgripstrengthiscontralateralpercentagehassignifＧicantlyimprovedaftertreatmentinflexion,dorsiflexion,ulnardeviation,radialdeviation,gripstrengthcontralateralpercentageissignificantdifference(P ＜０．０５);thetotaleffect,goodrateof６０．８７％,totaleffectiveratewas８６．９６％;decreasedsignificantlyaftertreatmentcomparedwithbeforetreatmentonlimbpain,andinthefunctionalactivities,wristactivityhandfineoperation,liftingabilityandself－perceptionisbeforetreatmentsignificantlyimprovedaftertreatmenttoassessthesixthaspectsignificantdifference(p＜０．０５)inthelimbfunction;aftertreatmentofmotionforthedistrictaverageincrease(１０．２ plusmn; １．６)deg;,musclestrengthincreasedmorethan４casesofgradeⅠ,Ⅱ grade５cases,gradeⅢandabove２cases．Thereare８casesofrecoveryfeelgoodontheskin．Conclusion　thedistalradiusbonegiantcelltumorresectionof