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全肩胛切除术后的约束性假体重建。

Reconstruction with constrained prosthesis after total scapulectomy.

机构信息

Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing, China.

出版信息

J Shoulder Elbow Surg. 2011 Oct;20(7):1163-9. doi: 10.1016/j.jse.2010.12.014. Epub 2011 Apr 27.

Abstract

HYPOTHESIS

Scapular prosthetic replacement after total scapulectomy can result in oncologic salvage and good postoperative function with a low rate of complications.

MATERIALS AND METHODS

Ten patients who underwent constrained scapular prosthetic replacement after total scapulectomy between 2003 and 2009 were reviewed retrospectively.

RESULTS

At a mean follow-up of 36 months, 2 patients died of their disease. One patient showed recurrence and metastasis. Complications, including dislocation and superficial wound infection, occurred in 2 patients. The mean Musculoskeletal Tumor Society 93 score was 23.2 of 30 points. High scores were achieved for most items except hand position; only 5 patients can raise their hands above their waist. The ranges of active shoulder abduction and forward flexion motion were 20° to 45° and 40° to 65°, respectively. All patients retained normal hand and elbow functions.

CONCLUSION

Although there are limitations in the shoulder's active motion, reconstruction with a scapular prosthesis can provide oncologic salvage and result in good postoperative function with a low rate of complications.

摘要

假设

全肩胛切除术(total scapulectomy)后进行肩胛骨假体置换可实现肿瘤学挽救(oncologic salvage),并获得良好的术后功能,同时并发症发生率较低。

材料与方法

回顾性分析了 2003 年至 2009 年间 10 例接受全肩胛切除术后约束性肩胛骨假体置换的患者。

结果

平均随访 36 个月时,2 例患者死于疾病,1 例患者出现复发和转移。2 例患者出现并发症,包括脱位和浅表伤口感染。肌肉骨骼肿瘤学会 93 分平均得分为 30 分中的 23.2 分。除手的位置外,大多数项目的得分较高,仅 5 例患者能够将手举过腰部。主动肩外展和前屈运动的范围分别为 20°至 45°和 40°至 65°。所有患者均保留正常的手和肘部功能。

结论

尽管肩部主动运动存在局限性,但肩胛骨假体重建可实现肿瘤学挽救,并获得良好的术后功能,同时并发症发生率较低。

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