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桡骨远端关节面内生性 Campanacci 3 级巨细胞瘤切除后应用游离带血管腓骨头移植重建腕关节

Wrist Reconstruction Using Free Vascularized Fibular Head Graft Following Intralesional Excision for Campanacci Grade 3 Giant Cell Tumors Involving the Articular Surface of the Distal Radius.

机构信息

Department of Orthopedic Surgery, College of Medicine, Kyung Hee University, Seoul, South Korea.

Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.

出版信息

J Hand Surg Am. 2022 Dec;47(12):1231.e1-1231.e6. doi: 10.1016/j.jhsa.2021.09.036. Epub 2021 Dec 9.

Abstract

Reconstruction with a free vascularized fibular head graft after en bloc excision of a Campanacci grade 3 giant cell tumor of bone in the distal radius can effectively control local recurrence. However, it leads to the loss of wrist movement, subsequent radiocarpal subluxation, and an osteoarthritic change. Another treatment option for grade 3 lesions is intralesional excision and cementation, which preserves wrist movement but does not restore the articular surface. We report a case of wrist reconstruction using a free vascularized fibular head graft after the intralesional excision of a Campanacci grade 3 giant cell tumor of bone with invasion of the articular surface of the distal radius. In patients with this type of a lesion, wrist reconstruction using a free vascularized fibular head graft after intralesional excision can help prevent local tumor recurrence, restore the articular surface, and maintain movements of the wrist joint.

摘要

在整块切除桡骨远端 Campanacci 3 级巨细胞瘤后,采用游离腓骨头移植重建,可以有效控制局部复发。但会导致腕关节活动丧失、随后发生桡腕关节半脱位和骨关节炎改变。3 级病变的另一种治疗选择是病灶内切除和骨水泥填充,这种方法可以保留腕关节活动度,但无法恢复关节面。我们报告了一例桡骨远端关节面受侵犯的 Campanacci 3 级骨巨细胞瘤病灶内切除后,采用游离腓骨头移植重建腕关节的病例。对于此类病变患者,病灶内切除后采用游离腓骨头移植重建腕关节有助于预防局部肿瘤复发、恢复关节面并维持腕关节活动度。

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