Pu Feifei, Yu Yihan, Zhang Zhicai, Liu Jianxiang, Shao Zengwu, Chen Fengxia, Feng Jing
Department of Orthopaedics, Wuhan Hospital of Traditional Chinese and Western Medicine (Wuhan No. 1 Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.
Mol Clin Oncol. 2023 Feb 16;18(4):27. doi: 10.3892/mco.2023.2623. eCollection 2023 Apr.
There is no unified surgical plan for fibular proximal malignant tumours; therefore, the present study retrospectively analysed the medical records of 19 patients with primary malignant and invasive tumours in the proximal fibula and discussed the postoperative oncological results, complications and postoperative functions of limb salvage surgery. According to pathological classification, there were 10 osteosarcoma cases, 3 chondrosarcoma cases, 2 invasive giant cell osteosarcoma tumour cases, 1 epithelioid sarcoma case, 1 leiomyosarcoma case, 1 fibrosarcoma case and 1 lymphoma case. According to the Enneking instalment, IB stage was found in 2 cases, IIA in 2 cases and IIB in 15 cases. A total of 3 patients underwent Malawer I resection, and 16 patients underwent Malawer II resection. The follow-up period was 11-174 months, with an average of 76.58 months. Local recurrence occurred in three patients and distant metastasis in seven patients; 4 patients succumbed and 15 survived. After biceps femoris tendon reconstruction and lateral collateral ligament insertion, 18 patients had good knee stability. The Musculoskeletal Tumour Society scale ranged between 23 and 29 points, with an average of 27.26 points; the Lysholm Knee Score was 65-84 points, with an average of 83 points. After the resection of proximal fibula primary and invasive tumours, the biceps femoris tendon and lateral collateral ligament insertion point was reconstructed. The data show that this technique can effectively reconstruct stability and restore knee function.
目前对于腓骨近端恶性肿瘤尚无统一的手术方案；因此，本研究回顾性分析了19例腓骨近端原发性恶性和侵袭性肿瘤患者的病历，探讨了保肢手术的术后肿瘤学结果、并发症及术后肢体功能。根据病理分类，骨肉瘤10例，软骨肉瘤3例，侵袭性巨细胞骨肉瘤2例，上皮样肉瘤1例，平滑肌肉瘤1例，纤维肉瘤1例，淋巴瘤1例。根据Enneking分期，IB期2例，IIA期2例，IIB期15例。3例患者接受了Malawer I型切除，16例患者接受了Malawer II型切除。随访时间为11 - 174个月，平均76.58个月。3例出现局部复发，7例发生远处转移；4例死亡，15例存活。在进行股二头肌肌腱重建和外侧副韧带附着点重建后，18例患者膝关节稳定性良好。肌肉骨骼肿瘤学会评分在23至29分之间，平均27.26分；Lysholm膝关节评分在65至84分之间，平均83分。在切除腓骨近端原发性和侵袭性肿瘤后，对股二头肌肌腱和外侧副韧带附着点进行了重建。数据表明，该技术可有效重建稳定性并恢复膝关节功能。
