Ippolito V, Saccalani M, Ianni L, Spaggiari L, Cavina F, Modonesi F, Bonetti L, Sartori G
Centro di Oncologia Ortopedica, Ospedale Civile, Brescia.
Chir Organi Mov. 2003 Apr-Jun;88(2):165-9.
In the surgical treatment of metastatic lesions of the proximal humerus it is important to find solutions that eliminate pain and solve the mechanical problem in a short time and with reduced costs. In 90% of cases, intralesional curettage, freezing with liquid nitrogen and cement enhanced intramedullary instrumentation is capable of brilliantly solving the problems of these patients. When, instead, osteolysis involves the greater tuberosity and/or the joint region, resection of the proximal humerus followed by reconstruction with a modular prosthesis is indicated. Of those available on the market, the RPS system (LIMA) has features that make it equivalent to others, but at costs considerably lower. However, in reconstructions with prostheses, active abduction is significantly limited. A personal series of 20 patients is presented.
在肱骨近端转移瘤的外科治疗中,找到能在短时间内以较低成本消除疼痛并解决机械问题的解决方案很重要。在90%的病例中,病灶内刮除、液氮冷冻和骨水泥增强髓内固定能够出色地解决这些患者的问题。相反,当骨溶解累及大结节和/或关节区域时,则建议行肱骨近端切除,然后用模块化假体进行重建。在市场上现有的产品中,RPS系统(LIMA)具有与其他产品相当的特性,但成本要低得多。然而,在假体重建中,主动外展明显受限。本文介绍了一组20例患者的个人病例系列。