儿童骨肿瘤术后下肢不等长治疗策略的研究进展
Advances in treatment strategies for postoperative leg length discrepancy in pediatric bone tumors
徐鸿锋 1刘巍峰1
作者信息
- 1. 首都医科大学附属北京积水潭医院(北京大学第四临床医学院)骨肿瘤科,北京 100035
- 折叠
摘要
过去十年,儿童骨肿瘤领域下肢延长技术研究进展显著,以ilizarov牵张成骨为核心,通过个体化调整牵拉速度促进新生骨生成.外固定装置(如Ilizarov环形架和单边支架)虽操作便捷,但疗程长、并发症多,而优化固定方法和药物辅助再生成为研究热点.针对特定情况(如骨缺损＜5 cm),骨骺生长调节技术可提供治疗选项.可延长假体,尤其是针对大段骨缺损,其微创和无创设计减少了并发症,但仍需改进材料、结构以应对感染和机械故障.髓内延长钉(如Precice钉)表现出高舒适度和低感染风险,但并发症管理不可忽视.目前治疗策略强调个性化,通过改进材料和固定技术缩短治疗周期,降低并发症发生率.未来国产化骨延长技术的发展与成本降低是研究与实践的关键,旨在提升儿童骨肿瘤手术后下肢不等长患儿的生活质量和减少并发症的发生率.
Abstract
Over the past decade,significant progress has been made in pediatric bone tumor lower limb lengthening tech-niques,with Ilizarov stretching osteogenesis as the fundamental foundation.Individualized traction adjustments facilitate efficient bone regeneration.While external fixation devices,such as Ilizarov circular frames and unilateral braces,offer user-friendly conve-nience,they often entail prolonged treatment durations and a myriad of associated complications.In cases with specific parame-ters,such as bone defects＜5 cm,epiphyseal growth modulation techniques present viable therapeutic avenues.Lengthening pros-theses can be employed,particularly for substantial bone defects,leveraging minimally invasive and non-invasive designs to miti-gate complications.There remains a pressing need to enhance materials and structural integrity effectively combat infections and mechanical failures.Intramedullary lengthening nails,exemplified by the Precice nail,boast high comfort and a low infection risk,yet effective complication management remains critical.Contemporary treatment paradigms prioritize individualized treatment plans,aiming to curtail treatment durations and complications through material enhancements and refined fixation methodologies.The forthcoming evolution and cost-effectiveness of domestically manufactured bone lengthening technologies represent pivotal realms of scholarly inquiry and practical application,with the overarching objective of ameliorating the quality of life for children contending with limb length discrepancies post bone tumor surgery while simultaneously diminishing complication rates.
关键词
儿童/骨肿瘤/下肢/骨延长术Key words
Child/Bone neoplasms/Lower extremity/Bone lengthening引用本文复制引用
基金项目
国家重点研发计划(2021YFC2400500)
国家重点研发计划(2023YFB4706300)
北京市自然科学基金(L212042)
北京积水潭医院"学科骨干"计划专项(XKGG202105)
出版年
2024
NETL
NSTL
万方数据