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18只患有犬桡骨远端骨肉瘤的犬进行保肢手术的手部外侧移位术

Lateral manus translation for limb-sparing surgery in 18 dogs with distal radial osteosarcoma in dogs.

作者信息

Séguin Bernard, Walsh Peter J, Ehrhart E J, Hayden Eva, Lafferty Mary H, Selmic Laura E

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.

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

出版信息

Vet Surg. 2019 Feb;48(2):247-256. doi: 10.1111/vsu.13132. Epub 2018 Nov 23.

Abstract

OBJECTIVE

To describe and report outcomes after lateral translation of the manus for limb-sparing management of distal radial osteosarcoma in dogs.

STUDY DESIGN

Retrospective case series.

STUDY POPULATION

Eighteen client-owned dogs.

METHODS

The distal aspect of the affected radius and associated neoplastic tissues were excised. The distal aspect of the ulna was preserved except for its medial cortex, which was removed en bloc with the radial segment. The manus was translated laterally to place the radial carpal bone in contact with the distal aspect of the ulna. A limb-sparing or locking compression plate was placed on the remaining proximal radius and the 3rd metacarpal bone. A 3.5-mm SOP (string of pearls) plate was placed on the lateral aspect of the proximal ulna and the 4th metacarpal bone. Dogs were administered chemotherapy. Data were collected to assess surgical and oncologic outcomes. Limb function was subjectively assessed.

RESULTS

The percentage of radius removed ranged from 43% to 94% (median 54%). Complications developed in 12 limbs, with infection in 10, biomechanical complications in 6, and local recurrence in 4. Limb function was subjectively assessed as acceptable. Median disease-free interval was 219 days, and median survival time was 370 days.

CONCLUSION

Outcomes after lateral translation of the manus compared favorably to other limb-sparing techniques for dogs with distal radial osteosarcoma, particularly in dogs requiring excision of a large segment of the radius.

CLINICAL SIGNIFICANCE

The lateral manus translation provides an alternative limb-sparing technique that does not require an allograft, endoprosthesis, or autograft.

摘要

目的

描述并报告犬桡骨远端骨肉瘤保肢治疗中手部外侧移位后的结果。

研究设计

回顾性病例系列。

研究对象

18只客户拥有的犬。

方法

切除患侧桡骨远端及相关肿瘤组织。尺骨远端除内侧皮质外予以保留,内侧皮质与桡骨段一并整块切除。将手部向外侧移位,使桡腕骨与尺骨远端接触。在剩余的近端桡骨和第三掌骨上放置一块保肢板或锁定加压钢板。在近端尺骨外侧和第四掌骨上放置一块3.5毫米的珍珠链钢板。对犬进行化疗。收集数据以评估手术和肿瘤学结果。对肢体功能进行主观评估。

结果

桡骨切除百分比范围为43%至94%(中位数为54%)。12条肢体出现并发症,其中10条肢体感染,6条肢体出现生物力学并发症,4条肢体局部复发。肢体功能主观评估为可接受。无病间期中位数为219天,中位生存时间为370天。

结论

对于患有桡骨远端骨肉瘤的犬,手部外侧移位后的结果与其他保肢技术相比具有优势,特别是对于需要切除大部分桡骨的犬。

临床意义

手部外侧移位提供了一种无需同种异体移植、假体或自体移植的保肢替代技术。

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