Winkelmann W W
Klinik und Poliklinik für Allgemeine Orthopädie, Westfälischen Wilhems-Universität, Münster.
Z Orthop Ihre Grenzgeb. 1992 May-Jun;130(3):197-201. doi: 10.1055/s-2008-1040138.
In the majority of cases with malignant tumors in the proximal part of the humerus a limb saving tumor resection is possible. Reconstruction of the defect is necessary to maintain the length of the arm and to create a fulcrum for elbow flexion and extension. Several methods of reconstruction have been described in the literature including the fixation of distal humerus to the second rib or to the clavicle by means of Küntscher-nails, the implantation of a proximal humerus prosthesis without or with accompanying bone transplantation, a bridging of the defect using an allograft or an arthrodesis of the shoulder joint using free or vascularized bone transplants. The following paper describes a new surgical procedure whereby the vascularization of the clavicle is preserved and the clavicle used to bridge the defect. Although the follow-up period of the patients operated on so far in this way is relatively short, the functional advantages of this operation over the other forms of reconstruction can already be observed.
在大多数肱骨近端恶性肿瘤病例中,保肢肿瘤切除术是可行的。必须对缺损进行重建,以维持手臂长度,并为肘关节屈伸创造一个支点。文献中描述了几种重建方法,包括通过克氏针将肱骨远端固定于第二肋骨或锁骨、植入有无骨移植伴随的肱骨近端假体、使用同种异体骨移植桥接缺损或使用游离或带血管骨移植对肩关节进行关节融合术。以下论文描述了一种新的手术方法,该方法保留了锁骨的血运,并使用锁骨来桥接缺损。尽管目前以这种方式接受手术的患者随访期相对较短,但已可观察到该手术相对于其他重建方式的功能优势。