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马拉韦尔IVB型肩胛带切除术后肩稳定性的新特殊方法:一例报告。

New special approach for shoulder stability after Malawer type IVB shoulder girdle resection: A case report.

作者信息

Furuta T, Sakuda T, Oae K, Harada Y, Arihiro K, Adachi N

机构信息

Department of Orthopaedic Surgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.

Department of Orthopaedic Surgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.

出版信息

Int J Surg Case Rep. 2022 Jun;95:107189. doi: 10.1016/j.ijscr.2022.107189. Epub 2022 May 11.

Abstract

INTRODUCTION AND IMPORTANCE

Scapular prostheses are useful in shoulder stability after shoulder girdle resection for malignant bone tumors; however, they are difficult to obtain in Japan. Therefore, other methods must be considered, depending on the extent of resection. We report a case in which a clavicle-locking plate, Nesplon tape, and a proximal humeral prosthesis were used to ensure shoulder stability and preserve stable upper limb function.

CASE PRESENTATION

A 56-year-old man presented with a large mass and edema over the entire right scapula, which caused severe pain, limited the shoulder's range of motion, and impaired function of the entire upper extremity. Clinical imaging and pathological findings indicated a diagnosis of conventional chondrosarcoma. Using the Malawer technique type IVB, we resected the shoulder girdle and secured shoulder stability with a clavicle-locking plate, Nesplon tape, and a proximal humeral prosthesis. To evaluate the patient, we obtained his Musculoskeletal Tumor Society (MSTS) and Disabilities of Arm, Shoulder, and Hand (DASH) scores 3 months postoperatively.

CLINICAL DISCUSSION

To preserve the function of the patient's elbow and hand, the stability of his shoulder was important. We could achieve this stability by using a prosthesis available in Japan. The patient's MSTT and DASH scores improved remarkably.

CONCLUSION

A clavicle-locking plate, Nesplon tape, and a proximal humeral prosthesis can be used to ensure shoulder stability after scapular girdle resection and can preserve or improve upper limb function.

摘要

引言与重要性

肩胛骨假体对于恶性骨肿瘤行肩胛带切除术后的肩部稳定性很有用;然而,在日本很难获得。因此,必须根据切除范围考虑其他方法。我们报告一例使用锁骨锁定钢板、Nesplon带和肱骨近端假体来确保肩部稳定性并保留稳定上肢功能的病例。

病例介绍

一名56岁男性,整个右肩胛骨出现巨大肿块和水肿,导致严重疼痛,限制了肩部活动范围,并损害了整个上肢的功能。临床影像学和病理检查结果表明诊断为传统型软骨肉瘤。我们采用Malawer IVB型技术切除了肩胛带,并用锁骨锁定钢板、Nesplon带和肱骨近端假体确保了肩部稳定性。为了评估患者,我们在术后3个月获得了他的肌肉骨骼肿瘤学会(MSTS)评分和上肢、肩部和手部功能障碍(DASH)评分。

临床讨论

为了保留患者肘部和手部的功能,其肩部的稳定性很重要。我们通过使用日本现有的假体实现了这种稳定性。患者的MSTT和DASH评分显著改善。

结论

锁骨锁定钢板、Nesplon带和肱骨近端假体可用于确保肩胛带切除术后的肩部稳定性,并可保留或改善上肢功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47fe/9127565/ca92fb47d872/gr1.jpg

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