tailieunhanh - Xương ác tính khối u

Cắt cụt chi, các trụ cột của oz điều trị các khối u xương ác tính, và Bây giờ là chọn lọc đã qua sử dụng không thường xuyên. Hầu hết bệnh nhân là ứng cử viên cho các đại lý thủ tục limbsparing hiệu quả hóa trị liệu Because Of trung đoàn Thể thức và hình ảnh được cải thiện, và tiến bộ trong phẫu thuật tái tạo. | Malignant Bone Tumors Limb Sparing Versus Amputation Matthew R. DiCaprio MD and Gary E. Friedlaender MD Abstract Amputation once the mainstay of treatment of malignant bone tumors now is used selectively and infrequently. Most patients are candidates for limbsparing procedures because of effective chemotherapeutic agents and regimens improved imaging modalities and advances in reconstructive surgery. Patient age as well as tumor location and extent of disease help define the most appropriate surgical alternatives. Options for skeletal reconstruction include modular endoprostheses osteoarticular or bulk allografts allograft-prosthetic composites vascularized bone grafts arthrodesis expandable prostheses rotationplasty and limb-lengthening techniques. Two key factors must be considered survival rates should be no worse than those associated with amputation and the reconstructed limb must provide satisfactory function. Functional outcome studies comparing limb-sparing procedures and amputation have inherent limitations including the inability to randomize treatment and the subjective nature of important outcome measures. J Am Acad Orthop Surg 2003 11 25-37 Primary malignant bone tumors are rare lesions with fewer than 3 000 new cases per year in the United States. Before the 1970s management routinely consisted of transbone amputations or disarticulations with dismal survival rates 10 to 20 . With the development of more effective chemotherapeutic agents and treatment protocols in the 1970s and 1980s survival rates improved which allowed the focus of management to shift to limb Computed tomography and magnetic resonance imaging MRI allow the precise visualization of the anatomic location of a tumor and its relation to surrounding structures. Preoperative planning has been advanced through the use of these modalities fostering better patient selection for specific treatment strategies and lowering the morbidity rates of biopsy and subsequent