Ruggieri P, Mavrogenis A F, Guerra G, Mercuri M
Istituto Ortopedico Rizzoli, 1/10 via di Barbiano, 40136 Bologna, Italy.
J Bone Joint Surg Br. 2011 Aug;93(8):1098-103. doi: 10.1302/0301-620X.93B8.26011.
We retrospectively studied 14 patients with proximal and diaphyseal tumours and disappearing bone (Gorham's) disease of the humerus treated with wide resection and reconstruction using an allograft-resurfacing composite (ARC). There were ten women and four men, with a mean age of 35 years (8 to 69). At a mean follow-up of 25 months (10 to 89), two patients had a fracture of the allograft. In one of these it was revised with a similar ARC and in the other with an intercalary prosthesis. A further patient had an infection and a fracture of the allograft that was revised with a megaprosthesis. In all patients with an ARC, healing of the ARC-host bone interface was observed. One patient had failure of the locking mechanism of the total elbow replacement. The mean post-operative Musculoskeletal Tumor Society score for the upper extremity was 77% (46.7% to 86.7%), which represents good and excellent results; one patient had a poor result (46.7%). In the short term ARC effectively relieves pain and restores shoulder function in patients with wide resection of the proximal humerus. Fracture and infection remain significant complications.
我们回顾性研究了14例肱骨近端和骨干肿瘤合并骨质溶解（戈勒姆病）的患者，这些患者接受了广泛切除并用同种异体骨表面置换复合材料（ARC）进行重建。其中有10名女性和4名男性，平均年龄为35岁（8至69岁）。平均随访25个月（10至89个月），2例患者出现同种异体骨骨折。其中1例用类似的ARC进行了翻修，另1例用节段性假体进行了翻修。另有1例患者发生感染和同种异体骨骨折，用大型假体进行了翻修。在所有使用ARC的患者中，均观察到ARC与宿主骨界面愈合。1例患者全肘关节置换的锁定机制失效。上肢术后肌肉骨骼肿瘤学会平均评分为77%（46.7%至86.7%），代表良好和优秀的结果；1例患者结果较差（46.7%）。短期内，ARC可有效缓解肱骨近端广泛切除患者的疼痛并恢复肩部功能。骨折和感染仍然是严重的并发症。
