Saleh Ruksal, Yurianto Henry, Pasallo Padlan, Guatama Astrawinata, Subagio Erich S
Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Makassar, Indonesia.
Orthopaedy and Traumatology Department, Hasanuddin University School of Medicine, Makassar, Indonesia.
Int J Surg Case Rep. 2019;61:254-258. doi: 10.1016/j.ijscr.2019.07.075. Epub 2019 Aug 1.
Giant cell tumor (GCT) is benign aggressive tumors with a high rate of recurrence and capacity to metastasize. Wide resection is the treatment of choice, but this creates a flaw at the proximal end of the humerus. There are various methods exist as the treatment option to fixed this problem.
We here present our experience on wide resection and free vascularized autogenous fibula head grafting for GCT at the proximal humerus of a 32 years old male. We performed free vascularized fibular head graft (FVFHG) as a reconstruction method followed by sling procedure and used the long head of biceps tendon. Evaluation of anatomical, functional, and radiological outcomes of this management was performed. After 3 years, the patient has a good outcome.
Free vascularized fibula graft is the most favored as a treatment after resection of a tumor on the proximal humerus. The advantages are can be harvested without many difficulties and rapid healing. In our case, we used a free vascularized fibular head graft (FVFHG) for proximal humerus reconstruction after resection giant cell tumor (GCT) on the right proximal humerus. We use the peroneal artery as vascular pedicle due to well vascularity to the peripheral part of fibula. There is no fibula head reabsorption after three years post-operation.
FVFHG for reconstruction modality as the treatment after resection of GCT grade Campanacci 3 on proximal humerus shows satisfactory result following long term evaluation.
骨巨细胞瘤(GCT)是具有高复发率和转移能力的良性侵袭性肿瘤。广泛切除是首选治疗方法,但这会在肱骨近端造成缺损。存在多种方法可作为解决此问题的治疗选择。
我们在此展示了对一名32岁男性肱骨近端骨巨细胞瘤进行广泛切除和游离带血管自体腓骨头移植的经验。我们采用游离带血管腓骨头移植(FVFHG)作为重建方法,随后进行吊带手术并使用肱二头肌长头肌腱。对该治疗的解剖学、功能和放射学结果进行了评估。3年后,患者取得了良好的效果。
游离带血管腓骨移植是肱骨近端肿瘤切除后最受青睐的治疗方法。其优点是取材难度不大且愈合迅速。在我们的病例中,我们对右侧肱骨近端骨巨细胞瘤切除后采用游离带血管腓骨头移植(FVFHG)进行肱骨近端重建。由于腓骨外周血供良好,我们使用腓动脉作为血管蒂。术后三年未出现腓骨头吸收。
对于肱骨近端Campanacci 3级骨巨细胞瘤切除后采用FVFHG重建方式进行治疗,长期评估显示结果令人满意。