Kesani A K, Tuy B, Beebe K, Patterson F, Benevenia J
Department of Orthopaedics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07103, USA.
Clin Orthop Relat Res. 2007 Nov;464:210-6. doi: 10.1097/BLO.0b013e318156fb30.
Limb-salvage surgery for malignant and aggressive forearm tumors presents a unique surgical challenge. We performed single-bone forearm reconstructions after extensive resections of the radius and ulna in four patients for such tumors. Radiocarpal arthrodesis was performed in three patients. We recorded the presence of metastases or local recurrences, Musculoskeletal Tumor Society upper extremity scores, and complications. One patient had local recurrence and one died of metastases. The average Musculoskeletal Tumor Society score at the last followup was 26 of 30 (88%; range, 24-28). Complications included wound infection/necrosis, delayed union, nonunion, and acute carpal tunnel syndrome. Single-bone forearm reconstructive surgery provided satisfactory functional outcomes in these four patients, and we believe it is a reasonable treatment option for individuals with malignant or aggressive tumors of the forearm requiring massive bone resection.
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
对于恶性及侵袭性前臂肿瘤的保肢手术是一项独特的外科挑战。我们对4例此类肿瘤患者在广泛切除桡骨和尺骨后进行了单骨前臂重建。3例患者进行了桡腕关节融合术。我们记录了转移或局部复发情况、肌肉骨骼肿瘤学会上肢评分及并发症。1例患者出现局部复发，1例死于转移。末次随访时肌肉骨骼肿瘤学会评分平均为30分中的26分（88%；范围为24 - 28分）。并发症包括伤口感染/坏死、骨延迟愈合、骨不连和急性腕管综合征。单骨前臂重建手术在这4例患者中提供了满意的功能结果，我们认为对于需要进行大块骨切除的前臂恶性或侵袭性肿瘤患者，这是一种合理的治疗选择。
IV级，治疗性研究。有关证据级别的完整描述，请参见作者指南。
