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腓骨近端肿瘤的外科治疗：12例报告

Surgical management of proximal fibular tumors: A report of 12 cases.

作者信息

Inatani Hiroyuki, Yamamoto Norio, Hayashi Katsuhiro, Kimura Hiroaki, Takeuchi Akihiko, Miwa Shinji, Higuchi Takashi, Abe Kensaku, Taniguchi Yuta, Yamada Satoshi, Okamoto Hideki, Otsuka Takanobu, Tsuchiya Hiroyuki

机构信息

Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan; Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.

Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.

出版信息

J Bone Oncol. 2016 Jun 8;5(4):163-166. doi: 10.1016/j.jbo.2016.06.001. eCollection 2016 Nov.

DOI:10.1016/j.jbo.2016.06.001
PMID:28008377
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5154704/
Abstract

BACKGROUND/AIM: Aggressive benign or malignant tumors in the proximal fibula may require en bloc resection of the fibular head, including the peroneal nerve and lateral collateral ligament. Here, we report the treatment outcomes of 12 patients with aggressive benign or malignant proximal fibula tumors.

PATIENTS AND METHODS

Four patients with osteosarcoma and 1 patient with Ewing's sarcoma were treated with intentional marginal resections after effective chemotherapy, and 4 patients underwent fibular head resections without ligamentous reconstruction. Clinical outcomes were investigated.

RESULTS

The mean Musculoskeletal Tumor Society scores were 96% and 65% in patients without peroneal nerve resection and those with nerve resection, respectively. No patients complained of knee instability.

CONCLUSION

Functional outcomes after resection of the fibular head were primarily influenced by peroneal nerve preservation. If patients are good responders to preoperative chemotherapy, malignant tumors may be treated with marginal excision, resulting in peroneal nerve preservation and good function.

摘要

背景/目的：腓骨近端的侵袭性良性或恶性肿瘤可能需要整块切除腓骨头，包括腓总神经和外侧副韧带。在此，我们报告12例侵袭性良性或恶性腓骨近端肿瘤患者的治疗结果。

患者与方法

4例骨肉瘤患者和1例尤因肉瘤患者在有效化疗后接受了意向性边缘切除，4例患者接受了腓骨头切除且未进行韧带重建。对临床结果进行了调查。

结果

未切除腓总神经的患者和切除神经的患者的肌肉骨骼肿瘤学会平均评分分别为96%和65%。没有患者抱怨膝关节不稳定。

结论

腓骨头切除术后的功能结果主要受腓总神经保留情况的影响。如果患者对术前化疗反应良好，恶性肿瘤可采用边缘切除治疗，从而保留腓总神经并获得良好功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f44/5154704/b1ec61a89f62/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f44/5154704/cb73dce4ad43/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f44/5154704/b1ec61a89f62/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f44/5154704/cb73dce4ad43/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f44/5154704/b1ec61a89f62/gr2.jpg

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本文引用的文献

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Malignant proximal fibular tumors: surgical management of 112 cases.恶性腓骨近端肿瘤：112 例的手术治疗。
J Bone Joint Surg Am. 2012 Nov 21;94(22):e165. doi: 10.2106/JBJS.K.00953.
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Clin Orthop Relat Res. 2010 Nov;468(11):3056-62. doi: 10.1007/s11999-010-1464-8.
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Knee stability after resection of the proximal fibula.腓骨近端切除术后的膝关节稳定性。
腓骨原发性骨肿瘤的特征及术后临床和功能结局。
Jt Dis Relat Surg. 2022;33(2):419-425. doi: 10.52312/jdrs.2022.624. Epub 2022 Jul 6.
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J Am Acad Orthop Surg Glob Res Rev. 2021 Sep 14;5(9):e21.00207. doi: 10.5435/JAAOSGlobal-D-21-00207.
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Efficacy of Minimally Invasive Surgery on Giant Cell Tumour of the Bone: A Systematic Review.微创手术治疗骨巨细胞瘤的疗效：一项系统评价
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A posterior approach for curettage in giant cell tumor of bone in the proximal fibula.一种用于腓骨近端骨巨细胞瘤刮除术的后路入路。
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