Suzuki Rie, Tanaka Hiroyuki, Fujimoto Yudai, Watanabe Makiyo, Takenaka Satoshi, Tamiya Hironari
Department of Orthopedic Surgery, Osaka International Cancer Institute, Osaka, Japan.
Department of Sports Medical Science, Osaka University Graduate School of Medicine, Osaka, Japan.
J Hand Surg Glob Online. 2023 Feb 3;5(2):258-262. doi: 10.1016/j.jhsg.2023.01.006. eCollection 2023 Mar.
Bone and soft-tissue sarcomas infrequently develop in the hand and wrist. Given the complex anatomy of this area, wide resection with adequate margins often impairs hand function because of the resection of essential structures, including tendons, bones, and tissues adjacent to the sarcoma. Here, we present a case of primary synovial sarcoma adjacent to the dorsal side of the carpal bones, which were resected with hemi-resection of the carpus and resection of extensor tendons, followed by wrist joint arthrodesis and palmaris longus tendon grafting. Hand function was satisfactory despite some disability, and no evidence of local recurrence was observed at the 24-month postoperative follow-up. This method may be effective for not only achieving tumor resection with a negative margin but also preserving hand function.
骨肉瘤和软组织肉瘤很少发生于手部和腕部。鉴于该区域解剖结构复杂，因切除包括肌腱、骨骼和肉瘤周围组织等重要结构，广泛切除且切缘足够往往会损害手部功能。在此，我们报告一例原发性滑膜肉瘤位于腕骨背侧，行腕骨半切除及伸肌腱切除，随后进行腕关节融合和掌长肌腱移植。尽管仍有一些功能障碍，但手部功能令人满意，术后24个月随访未发现局部复发迹象。该方法不仅可能有效地实现切缘阴性的肿瘤切除，而且还能保留手部功能。
