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病例报告:使用非骨水泥型三维打印假体切除胫骨远端肿瘤后重建内踝(踝关节的四分之一)

Case Report: Reconstruction of Medialis Malleolus (1/4 of the Ankle Joint) After Resection of Distal Tibia Tumor With an Uncemented Three-Dimensional-Printed Prosthesis.

作者信息

Wang Shang, Luo Yi, Zhang Yuqi, Wang Yitian, Zheng Chuanxi, Tu Chongqi, Zhou Yong

机构信息

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Front Surg. 2022 Mar 24;9:844334. doi: 10.3389/fsurg.2022.844334. eCollection 2022.

Abstract

INTRODUCTION

Few patients presented with a distal tibial tumor that only invaded a small area of bone in the medial malleolus. There have been no previous cases in which only the medial or lateral malleolus was removed and reconstruction was complete. This article describes our attempt to reconstruct the medial malleolus (1/4 of the ankle joint) after resection of a distal tibial tumor with an uncemented three-dimensional (3D)-printed prosthesis.

CASE DESCRIPTION

A 39-year-old man presented with a lump in the right medial malleolus, and biopsy results suggested fibrosarcoma. To preserve the patient's normal bone and function, we only removed the medial malleolus and reconstructed the ankle joint using a personalized 3D-printed prosthesis. The patient had no complications other than necrosis of the skin flap that covered the wound. The patient recovered well after undergoing an additional skin flap transfer. Follow-up at 7 months and again at 3 years after surgery showed good ankle function and stability, with no pain or complications.

CONCLUSION

The 3D-printed partial ankle prosthesis had a good matching degree, strength, and osseointegration ability, but also had a few complications. The patient achieved satisfactory ankle function and stability. However, a longer follow-up period is needed, and more research is required to confirm the efficacy of the prosthesis.

摘要

引言

很少有患者出现仅侵犯内踝一小片骨区域的胫骨远端肿瘤。以前没有仅切除内踝或外踝并完成重建的病例。本文描述了我们在用非骨水泥型三维(3D)打印假体切除胫骨远端肿瘤后重建内踝(踝关节的四分之一)的尝试。

病例描述

一名39岁男性因右内踝肿块就诊,活检结果提示为纤维肉瘤。为保留患者的正常骨骼和功能,我们仅切除了内踝,并使用个性化3D打印假体重建了踝关节。除覆盖伤口的皮瓣坏死外,患者无其他并发症。在接受额外的皮瓣转移后,患者恢复良好。术后7个月及3年的随访显示踝关节功能和稳定性良好,无疼痛或并发症。

结论

3D打印的部分踝关节假体具有良好的匹配度、强度和骨整合能力,但也有一些并发症。患者获得了满意的踝关节功能和稳定性。然而,需要更长的随访期,并且需要更多研究来证实假体的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2266/8987288/dd35a13d1d7a/fsurg-09-844334-g0001.jpg

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