Lu Wan-Qing, Xiang Qing-Tian, Zuo Hong-Guang, Yu Ya-Jun, Pan Zhen-Guo, Zhao Feng-Dong
Shaoyifu Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang, China.
Zhongguo Gu Shang. 2011 Dec;24(12):1032-5.
To study the effects of the extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation for the treatment of stage II to III giant cell tumor of bone in the proximal humerus.
From March 2007 to March 2010, 7 patients with stage II to III giant cell tumor of bone in the proximal humerus were treated. Among the patients, 3 patients were male and 4 patients were female with a mean age of 34.6 years (ranged, 18 to 49 years). The mean course of disease was 19 months (ranged, 6 to 35 months). All the patients were confirmed to suffer stage II to III giant cell tumor of bone in the proximal humerus by pathology and X-ray examinations. Clinical manifestations of the patients included persistence aggravated pain of the shoulder, swelling in the proximate arm with obviously tenderness, activity limited of the joint. All the patients were treated with extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation. CMS and OSIS score system were used to evaluate shoulder function and shoulder stability.
All the patients were followed up, and the duration ranged from 14 to 35 months, with an average of 17 months. There were no serious complications or recurrence in all cases. One year after the surgery CMS and OSIS score system were 70.7 scores (ranged,63 to 82 scores) and 25.1 scores (ranged, 18 to 29 scores) respectively. According to evaluation for shoulder function, 2 patients got an excellent result and 5 good. According to evaluation of shoulder stability, 1 patient got an excellent result and 6 good.
Extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation for the treatment of stage II to III giant cell tumor of bone in the proximal humerus would not only preserve the upper extremity but also preserve the function of upper extremity.
探讨肱骨近端Ⅱ～Ⅲ期骨巨细胞瘤采用瘤段广泛切除、人工肱骨头置换并结合围手术期康复治疗的效果。
2007年3月至2010年3月，对7例肱骨近端Ⅱ～Ⅲ期骨巨细胞瘤患者进行治疗。患者中，男性3例，女性4例，平均年龄34.6岁（18～49岁）。平均病程19个月（6～35个月）。所有患者均经病理及X线检查确诊为肱骨近端Ⅱ～Ⅲ期骨巨细胞瘤。患者临床表现为肩部持续性疼痛加重、上臂近端肿胀伴明显压痛、关节活动受限。所有患者均采用瘤段广泛切除、人工肱骨头置换并结合围手术期康复治疗。采用CMS和OSIS评分系统评估肩关节功能及肩关节稳定性。
所有患者均获随访，随访时间14～35个月，平均17个月。所有病例均无严重并发症及复发。术后1年CMS和OSIS评分系统评分分别为70.7分（63～82分）和25.1分（18～29分）。根据肩关节功能评估，优2例，良5例。根据肩关节稳定性评估，优1例，良6例。
肱骨近端Ⅱ～Ⅲ期骨巨细胞瘤采用瘤段广泛切除、人工肱骨头置换并结合围手术期康复治疗，既能保留上肢，又能保留上肢功能。
