Injerto óseo ilíaco vascularizado para defecto óseo ilio-sacro…(I)

"Injerto óseo ilíaco vascularizado para defecto óseo ilio-sacro posterior a la extirpación de tumor."

Nishida, Jun MD *; Shiraishi, Hideo MD *; Okada, Kyoji MD +; Ehara, Shigeru MD ++; Shimamura, Tadashi MD *

Abstract:

We present the clinical outcome of five patients who had reconstruction of large osseous defects in the iliosacral region after excision of aggressive bone tumors using pedicled-or free-vascularized iliac bone grafts. Surgical margin, incidence of recurrence and metastasis, patient survival, time to bone union, and postoperative function were evaluated. Limb-salvage surgery resulted in wide excisions in two patients with giant-cell tumors of bone and chordoma, respectively, a marginal excision in one patient with a schwannoma, and intralesional excisions to preserve nerve roots in two patients with giant-cell tumors. There was no recurrence at final followup in any of the patients. Bone union required an average of 5.4 months. The postoperative functional results were excellent in all patients except for the patient with a chordoma. In one of the patients with a giant-cell tumor, the screws and rod were removed partially because of skin necrosis in the instrumentation area. This technique is considered a good alternative for reconstruction of a large osseous defect in the pelvis because graft harvest is relatively simple and rapid, especially if a pedicled iliac bone transfer is performed.

Clinical Orthopaedics & Related Research. 447:145-151, June 2006.