Peterson Joel R, Villalobos Camilo E, Zamora Rodolfo, Wittig James C
Bull Hosp Jt Dis (2013). 2015 Jul;73(3):190-7.
Tumors involving the distal humerus are extremely rare. Those tumors can be safely resected and then the extremity reconstructed. In this article, we present a series of patients treated with hinged semiconstrained modular distal humeral replacement for reconstruction following wide resection of tumors of the distal humerus. We retrospectively reviewed the charts of nine patients treated for tumors of the distal humerus between 2002 and 2013. The diagnoses consisted of three primaries, five metastatic, and one benign aggressive tumor. There were four male and five female patients ranging in age from 36 to 78 years old. Patients were followed for an average of 34 months (3 to 75 months). The functional status was rated using the Musculoskeletal Tumor Score System (MSTS). Five of the nine cases presented as a pathologic fracture. Six of the nine patients died of their diseases at a mean of 17 months after main surgery. Three patients were alive and disease-free at a mean follow-up of 69 months (63 to 75 months). Seven patients demonstrated significant improvement in their elbow pain after the endoprosthetic surgery. The MSTS score for the nine cases was 81% (63% to 97%). Tumors of the distal humerus can be safely resected through an anterior approach. Once the tumor is resected, the resultant defect is reconstructed with a modular semiconstrained prosthesis. This technique allows safe tumor resection with a low complication rate and good functional results.
累及肱骨远端的肿瘤极为罕见。这些肿瘤能够安全切除，然后对肢体进行重建。在本文中，我们介绍了一系列接受铰链式半限制模块化肱骨远端置换术治疗的患者，用于肱骨远端肿瘤广泛切除术后的重建。我们回顾性分析了2002年至2013年间9例接受肱骨远端肿瘤治疗患者的病历。诊断包括3例原发性肿瘤、5例转移性肿瘤和1例侵袭性良性肿瘤。有4例男性和5例女性患者，年龄在36岁至78岁之间。患者平均随访34个月（3至75个月）。使用肌肉骨骼肿瘤评分系统（MSTS）对功能状态进行评分。9例中有5例表现为病理性骨折。9例患者中有6例在主要手术后平均17个月死于疾病。3例患者存活且无疾病，平均随访69个月（63至75个月）。7例患者在内植物手术后肘部疼痛有显著改善。9例患者的MSTS评分为81%（63%至97%）。肱骨远端肿瘤可通过前路安全切除。一旦肿瘤切除，用模块化半限制假体重建由此产生的缺损。该技术可实现安全的肿瘤切除，并发症发生率低，功能结果良好。
