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病例报告:采用手术切除治疗锁骨外侧骨内血管瘤,并使用三维打印个性化假体进行重建。

Case report: Intraosseous hemangioma of the lateral clavicle treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis.

作者信息

Li Zhuangzhuang, Zou Chang, Lu Minxun, Zhang Yuqi, Gong Taojun, Wang Jie, Luo Yi, Zhou Yong, Min Li, Tu Chongqi

机构信息

Department of Orthopedics, Orthopaedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.

Model Worker and Craftsman Talent Innovation Workshop of Sichuan province, Chengdu, Sichuan, China.

出版信息

Front Bioeng Biotechnol. 2023 Jan 9;10:1085674. doi: 10.3389/fbioe.2022.1085674. eCollection 2022.

Abstract

Intraosseous hemangiomas occurring the clavicle is uncommon. Reconstruction of the clavicle is suggested to maintain the normal shoulder joint function and prevent adverse outcomes. Complex anatomy shape of the clavicle remains a great challenge for prosthetic reconstruction of the clavicle. A 37-year-old female with no conclusive history of trauma presented with progressive mass at the right lateral clavicle for 5 years. The patient was treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis. Postoperatively radiographic examinations revealed a good position of the prosthesis, neither breakage nor loosening was detected. The right shoulder mobility returned to approximate level of preoperative shoulder 2 months after surgical reconstruction, with the range of motion of flexion 80°, extension 40°, abduction 80°, adduction 30°, external rotation 55°, and internal rotation 60°. The patient maintained the normal shoulder function during the 48 months follow-up period. There was no pain during shoulder motion. The Musculoskeletal Tumor Society Score (MSTS) score was 29 and the Functional Evaluation Form recommended by the American Shoulder and Elbow Surgeons (ASES) score was 95. 3D-printed personalized prosthesis is a good option to reconstruct the lateral clavicle bone defect and restore the shoulder support structure. It maintains the normal shoulder joint function and avoids adverse effects on daily activities after claviculectomy.

摘要

发生于锁骨的骨内血管瘤并不常见。建议对锁骨进行重建以维持正常的肩关节功能并防止不良后果。锁骨复杂的解剖形状对锁骨的假体重建仍然是一个巨大的挑战。一名37岁女性,无明确外伤史,右侧锁骨外侧出现进行性肿块5年。该患者接受了手术切除,并采用三维打印个性化假体进行重建。术后影像学检查显示假体位置良好,未检测到断裂或松动。手术重建2个月后,右肩部活动度恢复到术前大致水平,屈曲活动范围为80°,伸展40°,外展80°,内收30°,外旋55°,内旋60°。在48个月的随访期内,患者保持了正常的肩部功能。肩部活动时无疼痛。肌肉骨骼肿瘤学会评分(MSTS)为29分,美国肩肘外科医生推荐的功能评估表评分(ASES)为95分。三维打印个性化假体是重建锁骨外侧骨缺损和恢复肩部支撑结构的良好选择。它能维持正常的肩关节功能,避免锁骨切除术后对日常活动产生不良影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/783a/9868392/e1ff5424705d/fbioe-10-1085674-g001.jpg

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