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肱骨远端巨细胞瘤的间插式肘关节切除与关节融合术:聊胜于无。

Intercalary Elbow Resection and Arthrodesis for Giant Cell Tumor of Distal Humerus: Something Is Better Than Nothing.

作者信息

Yadav Umesh, Nemani Mudit, Malik Manmeet, Paul Shagnik, Mittal Amandeep, Agrawal Gaurav K, Yadav Nishan

机构信息

Orthopedics, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND.

Orthopedics and Trauma, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND.

出版信息

Cureus. 2022 Sep 2;14(9):e28698. doi: 10.7759/cureus.28698. eCollection 2022 Sep.

Abstract

Giant cell tumor (GCT) of the bone is a benign, locally aggressive neoplasm of epiphyseal origin. Most common sites for GCTs include the distal femur, proximal tibia, and the distal end of radius with the distal humerus being involved rarely. GCT is predominantly managed by extended curettage followed by adjuvant therapy to reduce recurrence. Juxta-articular GCTs are difficult to manage due to the destruction of the articular cartilage and subchondral bone which necessitates the need for joint reconstruction or fusion to salvage the joint. Aggressive and recurrent GCTs can be managed by wide resection of the tumor to reduce local recurrence followed by joint reconstruction or fusion. Joint reconstruction using a total elbow arthroplasty has been described for limb salvage as it provides a good functional outcome. We present a case of an aggressive GCT of the distal humerus that was treated using wide resection with humero-ulnar arthrodesis as an alternative in situations where joint reconstruction is not possible due to the unavailability of the prosthesis or socio-economic factors. The patient was asymptomatic after two years of follow-up, had no signs of recurrence, and had good hand functions.

摘要

骨巨细胞瘤(GCT)是一种起源于骨骺的良性、局部侵袭性肿瘤。GCT最常见的部位包括股骨远端、胫骨近端和桡骨远端,肱骨远端很少受累。GCT主要通过扩大刮除术治疗,随后进行辅助治疗以降低复发率。关节周围GCT由于关节软骨和软骨下骨的破坏而难以处理,这就需要进行关节重建或融合以挽救关节。侵袭性和复发性GCT可通过广泛切除肿瘤以减少局部复发,随后进行关节重建或融合。使用全肘关节置换术进行关节重建已被描述用于肢体挽救,因为它能提供良好的功能结果。我们报告一例肱骨远端侵袭性GCT病例,该病例在由于假体不可用或社会经济因素无法进行关节重建的情况下,采用广泛切除并进行肱尺关节融合术作为替代治疗方法。随访两年后,患者无症状,无复发迹象,手部功能良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2851/9527064/8ae15c554134/cureus-0014-00000028698-i01.jpg

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