Deng Linglong, Zhao Xing, Wei Chi, Qu Wenqiang, Yu Li, Zhu Shaobo
Department of Orthopedics, ZhongNan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, P.R. China.
Department o2f Orthopedics, Taihe Hospital of Shiyan, Shiyan, Hubei, P.R. China.
J Int Med Res. 2019 Nov;47(11):5873-5882. doi: 10.1177/0300060519875336. Epub 2019 Oct 3.
Chondrosarcoma is characterized by the presence of histologically aggressive behavior, and commonly involves the scapula. Currently, limb salvage surgery is the recommended surgical treatment. Owing to the irregularity of the tumor, the suitability of an implant after tumor resection is a challenge for surgeons. Three-dimensional (3D) printing technology has the potential to make personalized limb salvage surgery a reality. We report the case of a 53-year-old man who was diagnosed with chondrosarcoma of the scapula. Considering the low-grade malignancy and lack of invasion of the glenoid, we agreed upon segmental scapula replacement as the treatment protocol. Nevertheless, reconstruction of the irregular bony defect remaining after tumor resection can be complicated. Therefore, a personalized prosthesis and navigation template corresponding to tumor was designed with 3D printing technique, and tumor resection, prosthesis implantation, and rotator cuff reconstruction were completed. The affected shoulder achieved satisfactory function during a 32-month follow-up with no tumor recurrence. 3D printing technique can help implement the individualized design of the implant and accurate reconstruction after tumor resection, simplify complicated operations, improve operational efficiency, and allow early functional recovery.
软骨肉瘤的特点是具有组织学上的侵袭性行为，且常累及肩胛骨。目前，保肢手术是推荐的外科治疗方法。由于肿瘤的不规则性，肿瘤切除后植入物的适配性对外科医生来说是一项挑战。三维（3D）打印技术有可能使个性化保肢手术成为现实。我们报告了一例53岁男性被诊断为肩胛骨软骨肉瘤的病例。考虑到肿瘤的低级别恶性以及未侵犯关节盂，我们商定采用肩胛骨节段性置换作为治疗方案。然而，肿瘤切除后剩余的不规则骨缺损的重建可能很复杂。因此，使用3D打印技术设计了与肿瘤相对应的个性化假体和导航模板，并完成了肿瘤切除、假体植入和肩袖重建。在32个月的随访期间，患肩功能恢复良好，无肿瘤复发。3D打印技术有助于实现植入物的个性化设计以及肿瘤切除后的精确重建，简化复杂手术，提高手术效率，并促进早期功能恢复。
