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犬桡骨远端大型骨肉瘤切除术中金属内置假体保肢手术的改良:病例报告

Modification of the metal endoprosthesis limb-salvage procedure for excision of a large distal radial osteosarcoma in a dog: A case report.

作者信息

Wustefeld-Janssens Brandan G, Lafferty Mary, Séguin Bernard

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas.

Flint Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.

出版信息

Vet Surg. 2018 Aug;47(6):802-808. doi: 10.1111/vsu.12924. Epub 2018 Jul 26.

Abstract

OBJECTIVE

To report modification of the endoprosthesis surgical limb-salvage technique to treat a locally extensive osteosarcoma in a dog and associated functional outcome.

STUDY DESIGN

Clinical case report.

ANIMALS

One client-owned dog.

METHODS

A 9-year-old dog was presented for treatment of a locally extensive distal radial osteosarcoma. A limb-salvage surgery was performed with a second-generation Veterinary Orthopedic Implants (VOI) endoprosthesis to reconstruct the radial segmental and carpal osseous defect. The endoprosthesis was stabilized with a 16-mm-wide locking VOI limb-salvage plate. The level of the osteotomy of the radius/ulna was 3 cm proximal to the periosteal reaction seen on radiographs, and the distal osteotomy extended through the proximal metacarpal bones (II-V), 3 cm from the distal extent of the soft tissue component of the tumor. A 3.5-mm SOP (String of Pearls) plate was used as adjunct fixation.

RESULTS

The postoperative functional outcome was classified as acceptable. Ambulation was normal, with mild subjective lameness on the treated limb at examinations 20, 43, and 63 days after surgery. The dog was euthanized 92 days after surgery because of progressive metastatic disease.

CONCLUSION

The modified endoprosthetic technique allowed complete excision of the carpal joint, which resulted in acceptable functional outcomes in the dog described here.

CLINICAL SIGNIFICANCE

Distal ostectomies may include part of the manus during limb salvage surgery of locally extensive distal radial osteosarcoma and using an endoprosthesis implant to reconstruct the defect.

摘要

目的

报告对假体手术保肢技术进行改良,以治疗犬局部广泛骨肉瘤及相关功能结果。

研究设计

临床病例报告。

动物

一只客户拥有的犬。

方法

一只9岁犬因局部广泛的桡骨远端骨肉瘤前来治疗。采用第二代兽医骨科植入物(VOI)假体进行保肢手术,以重建桡骨节段性和腕骨骨质缺损。使用一个16毫米宽的锁定VOI保肢钢板固定假体。桡骨/尺骨截骨水平在X线片上可见的骨膜反应近端3厘米处,远端截骨延伸至近端掌骨(II - V),距肿瘤软组织成分远端3厘米处。使用一个3.5毫米的珍珠链(SOP)钢板作为辅助固定。

结果

术后功能结果被分类为可接受。术后20、43和63天检查时,行走正常,患侧肢体有轻度主观跛行。术后92天,因疾病进展性转移对犬实施安乐死。

结论

改良的假体技术能够完全切除腕关节,在此处描述的犬中产生了可接受的功能结果。

临床意义

在局部广泛的桡骨远端骨肉瘤保肢手术中,远端截骨可能包括手部的一部分,并使用假体植入物重建缺损。

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