Department of Orthopaedic Surgery, Shinshu University School of Medicine, Nagano, Japan.
Jpn J Clin Oncol. 2022 Apr 6;52(4):370-374. doi: 10.1093/jjco/hyab207.
To predict the muscle strength and postoperative function for soft-tissue sarcoma arising from the adductor compartment of the thigh.
Between 2003 and 2019, 17 cases that underwent resection of the adductor muscle group (adductor longus, adductor magnus, adductor brevis, gracilis and pectineus) for soft-tissue sarcoma in the adductor compartment of the thigh were included. The muscle strength was measured with an isokinetic dynamometer for the knee joint and with a hand-held dynamometer for the hip joint (ratio of affected to unaffected side). The Musculoskeletal Tumor Society score, Toronto Extremity Salvage Score, European Quality of Life-5 Dimensions and maximum walking speed were used to assess postoperative function and examine correlations with muscle strength.
In 13 cases that underwent an isolated resection of the adductor compartment, reduced adduction strength correlated with increased number of resected muscles in the adductor muscle group (P < 0.001). Postoperative function was maintained, showing no correlations with adduction strength. In four cases that underwent combined resections of other compartments, a decrease was observed in adduction strength as well as the muscle strength of other resected muscles, in addition to a decline in postoperative function. In the 4 or 5 adductor muscle resection group, the comparison between isolated and combined resection revealed comparable results for adduction strength but a significant decrease in postoperative function for the combined resection group.
Postoperative function can be preserved for isolated adductor compartment resection. Combined resections of multiple muscles in other compartments and most adductor muscles may result in decreased postoperative function.
预测大腿收肌室软组织肉瘤的肌肉力量和术后功能。
2003 年至 2019 年间，共纳入 17 例在大腿收肌室接受收肌肌群（长收肌、大收肌、短收肌、股薄肌和耻骨肌）切除术治疗的软组织肉瘤患者。通过等速测力计测量膝关节肌肉力量，使用手持式测力计测量髋关节肌肉力量（患侧与健侧的比值）。采用肌肉骨骼肿瘤学会评分、多伦多肢体挽救评分、欧洲生活质量 5 维度评分和最大步行速度评估术后功能，并与肌肉力量进行相关性分析。
在 13 例单纯收肌室切除的病例中，内收力量的减弱与切除的收肌肌群中的肌肉数量增加呈正相关（P<0.001）。术后功能得以维持，与内收力量无相关性。在 4 例接受其他部位联合切除的病例中，除了其他切除肌肉的力量下降外，内收力量也下降，术后功能下降。在 4 或 5 个收肌切除组中，孤立切除和联合切除的比较显示，内收力量的结果相似，但联合切除组的术后功能显著下降。
对于单纯的收肌室切除术，可以保留术后功能。而对于其他部位多个肌肉的联合切除，以及大部分收肌的切除，可能会导致术后功能下降。
