Tang Xiaodong, Guo Wei, Yang Rongli, Tang Shun, Yang Yi
Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing, China.
J Shoulder Elbow Surg. 2009 Sep-Oct;18(5):796-803. doi: 10.1016/j.jse.2009.01.022. Epub 2009 Jul 1.
The options for reconstruction after excision of a tumor around the elbow are technically difficult and limited.
We retrospectively reviewed 25 patients who underwent custom-made endoprosthetic reconstruction after tumor resection near the elbow between 1998 and 2007.
At final follow-up, 14 patients (56%) were alive, and 11 (44%) had died of their disease. Local recurrence was encountered in 4 patients (16%). Complications occurred in 6 patients (24%), including vascular injury, neurapraxia of the radial nerve, and aseptic loosening in 4. The average Musculoskeletal Tumor Society 93 score was 23.9 points, and the average Mayo Elbow Performance score was 82 points. Pain was relieved in all patients, although some limitations of lifting ability were reported. Ten patients had an arc of elbow motion of more than 100 degrees after reconstruction.
In most patients, local tumor resection and prosthetic reconstruction of the elbow can be done with oncologic safety, and provides good function with low rates of complications.
肘部周围肿瘤切除术后的重建选择在技术上难度较大且有限。
我们回顾性分析了1998年至2007年间25例行肘部附近肿瘤切除术后定制型人工关节重建的患者。
末次随访时，14例患者（56%）存活，11例（44%）死于疾病。4例患者（16%）出现局部复发。6例患者（24%）发生并发症，包括血管损伤、桡神经失用症以及4例无菌性松动。肌肉骨骼肿瘤学会93评分平均为23.9分，梅奥肘关节功能评分平均为82分。所有患者疼痛均得到缓解，不过有部分患者报告存在提举能力受限的情况。10例患者重建后肘关节活动弧超过100度。
在大多数患者中，肘部局部肿瘤切除及假体重建在肿瘤学安全性方面可行，且并发症发生率低，功能良好。
