Tran Dung Trung, Tran Thanh Duc, Nguyen Son Ba, Nguyen Sang Quang Tran, Dang Quang Minh, Tran Cong Van
Department of Orthopaedic Surgery, College of Health Science, VinUniversity, Hanoi, Vietnam.
Orthopaedic and Sports Medicine Center, Vinmec Healthcare System, Hanoi, Vietnam.
Case Rep Oncol. 2022 Jan 13;15(1):12-20. doi: 10.1159/000519599. eCollection 2022 Jan-Apr.
Total humeral replacement is a complex surgery that requires many challenges to overcome such as the weight of the implant material and the shoulder function due to extensive resection of the rotator cuff. Improvements in implants material that is lighter than usual can lead to higher surgery success rates. We present a patient who was diagnosed with osteosarcoma of the right humerus. The patient received 2 cycles of MAP chemotherapy (included: doxorubicin, cisplatin, and methotrexate) before surgery. He underwent radical resection of osteosarcoma and total humerus replacement with a modified total humeral material. The purpose of this improvement was to reduce the implant's weight and to improve postoperative recovery. Six months after the surgery, the weight-bearing ability of the patient's shoulder within a wide range of movement has restored; the shoulder, elbow, and hand can move in a controlled way. Despite the short postoperative follow-up time, the improvement in the modified technique has brought many positive results. Total humerus replacement, which combines the reverse shoulder prosthesis, elbow prosthesis, and polyetheretherketone, is an appropriate solution for patients with osteosarcoma of the humerus instead of custom-made humerus megaprosthesis.
全肱骨置换术是一项复杂的手术，需要克服诸多挑战，如植入物材料的重量以及因广泛切除肩袖导致的肩部功能问题。采用比常规材料更轻的植入物材料可提高手术成功率。我们报告一名被诊断为右肱骨骨肉瘤的患者。该患者在手术前接受了2个周期的MAP化疗（包括：阿霉素、顺铂和甲氨蝶呤）。他接受了骨肉瘤根治性切除术，并使用改良的全肱骨材料进行了全肱骨置换。这种改良的目的是减轻植入物的重量并改善术后恢复情况。术后6个月，患者肩部在大范围活动内的负重能力已恢复；肩部、肘部和手部能够进行可控的活动。尽管术后随访时间较短，但改良技术已带来诸多积极成果。结合反向肩关节假体、肘关节假体和聚醚醚酮的全肱骨置换术，对于肱骨骨肉瘤患者而言，是一种比定制肱骨大型假体更为合适的解决方案。
