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가토의 대퇴골에서 이식한 자가골의 체외 방사선 조사에 따른 조직 형태학적 변화
김재도,임언,사석진 고신대학교 의학부 1999 高神大學校 醫學部 論文集 Vol.14 No.1-2
Background Skeletal reconstruction is an inevitable procedure when limb sparing operation is indicated in the treatment of the malignant bone tumor of extremities. After a bone tumor is widely resected, several procedures have been used such as tumor prosthesis, allograft, allograft-prosthesis composite, ordinary autograft, recycling autograft(autoclave, low heat treated, extracorporeal irradiated) to fill the large osseous defect. Methods The rabbits were divided into three groups according to the irradiation dose given to the separated femoral segment ; 0 (control), 20, and 50 Gy, respectively. A cortical bone segment of the unilateral femoral diaphysis in rabbit was resected, irradiated extracorporeally, and reimplanted immediately as an autograft, and then examined over a 8-week period by plain roentgenography, bone scan, gross and histologic findings. Results There were no definite difference among three groups. ; The osteotomy site was grossly stable with external callus formation. On plain roentgenography, the gap of osteotomy site was disappeared with abundant external callus formation. On bone scan, the uptake of radioactive isotope was increased in incorporated site compared with contralateral one. Histologically, the resorption of the graft began on the outer surface of cortex. New bone formation was confined around the osteotomy sites. It was much more prominent on the periosteal side than in the endosteal side in both the control and irradiated groups. Conclusion These results suggest that bone union is not affected by irradiation of 20 Gy to 50 Gy as used in this study. Therefore, extracorporeal irradiated autogenous bone graft can be used as a limb preserving procedure for the malignant bone tumor.
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