Szabo Robert M, Anderson Kurt A, Chen James L
Department of Orthopaedic Surgery, School of Medicine, University of California, Davis, Sacramento, 95817, USA.
J Hand Surg Am. 2006 Oct;31(8):1340-8. doi: 10.1016/j.jhsa.2006.06.004.
Multiple options have been reported for reconstruction of Campanacci grade 3 giant-cell tumor of the distal radius after resection. In 1990, the senior author described an allograft reconstruction combined with a Sauve-Kapandji procedure after distal radius resection and reported preliminary results in 3 patients. The purpose of this study was to assess with validated patient outcome surveys the intermediate to long-term outcomes of all patients treated with this surgery and to analyze their functional results and document tumor control.
All cases of distal radius osteoarticular allograft combined with the Sauve-Kapandji reconstruction for Campanacci grade 3 giant-cell tumors performed from 1986 to 2000 by a single surgeon were evaluated by clinical and radiologic examinations; the Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form-36; and Mayo Wrist scores.
Nine consecutive patients (7 women, 2 men) with an average age at follow-up evaluation of 42 years and with a Campanacci grade 3 giant-cell tumor of the distal radius formed the study population. Clinical follow-up time after reconstruction averaged 7 years. Examination showed an average of 51 degrees of extension and 19 degrees of flexion of the wrist and 63 degrees of supination and 79 degrees of pronation of the forearm. Grip strength measured in 5 patients averaged 23 kg. The Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form-36; and the Mayo Wrist scores averaged 15, 72, and 73, respectively. These scores indicate modest functional impact. No patient had tumor recurrence, metastases, nonunion, or proximal ulna instability.
En bloc resection of a Campanacci grade 3 giant-cell tumor of the distal radius followed by reconstruction with an osteoarticular allograft and a Sauve-Kapandji procedure with autogenous bone graft results in a reasonable functional outcome at intermediate to long-term follow-up evaluation.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
据报道，桡骨远端切除术后Campanacci 3级骨巨细胞瘤的重建有多种选择。1990年，资深作者描述了一种在桡骨远端切除术后采用同种异体骨重建联合Sauve-Kapandji手术的方法，并报告了3例患者的初步结果。本研究的目的是通过经过验证的患者结局调查来评估接受该手术治疗的所有患者的中长期结局，分析其功能结果并记录肿瘤控制情况。
对1986年至2000年由同一外科医生进行的所有桡骨远端骨关节同种异体骨联合Sauve-Kapandji重建治疗Campanacci 3级骨巨细胞瘤的病例进行临床和影像学检查评估；采用上肢、肩部和手部功能障碍问卷、简明健康状况调查问卷（Short Form-36）以及梅奥腕关节评分。
连续9例患者（7例女性，2例男性）纳入研究人群，随访评估时平均年龄为42岁，均为桡骨远端Campanacci 3级骨巨细胞瘤。重建术后临床随访时间平均为7年。检查显示，腕关节平均伸展度为51度，屈曲度为19度，前臂旋后度为63度，旋前度为79度。5例患者测量的握力平均为23千克。上肢、肩部和手部功能障碍问卷、简明健康状况调查问卷以及梅奥腕关节评分的平均值分别为15、72和73。这些评分表明功能影响较小。没有患者出现肿瘤复发、转移、骨不连或尺骨近端不稳定。
整块切除桡骨远端Campanacci 3级骨巨细胞瘤，随后采用骨关节同种异体骨重建和自体骨移植的Sauve-Kapandji手术，在中长期随访评估中可获得合理的功能结局。
研究类型/证据水平：治疗性IV级。
