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采用保肢手术治疗肘部周围原发性良性侵袭性或恶性骨肿瘤的疗效

Outcomes of management of primary benign aggressive or malignant bone tumors around the elbow by limb-salvage surgery.

作者信息

Ebeid Walid Atef, Badr Ismail Tawfeek, Mesregah Mohamed Kamal, Hasan Bahaa Zakarya

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

Department of Orthopaedic Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt.

出版信息

J Exp Orthop. 2023 Oct 23;10(1):105. doi: 10.1186/s40634-023-00675-z.

DOI:10.1186/s40634-023-00675-z
PMID:37870629
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10593692/
Abstract

PURPOSE

Bone tumors around the elbow are rare, with frequently delayed diagnosis. The current study aimed to assess the functional and oncological outcomes of limb salvage surgery for primary benign aggressive or malignant bone tumors around the elbow.

METHODS

We conducted a retrospective review of patients with primary aggressive benign and malignant bone tumors around the elbow treated with limb salvage surgery between 1995 and 2020 at a single musculoskeletal oncology center. The minimum follow-up period was 24 months. Functional results were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system at the last follow-up visit. Local recurrence, chest metastasis, and complications were recorded.

RESULTS

This study included 30 patients, 19 males and 11 females, with a mean age of 25.4 ± 14.2 years. The tumor location was the distal humerus (n = 21), proximal radius (n = 5), and proximal ulna (n = 4). Reconstruction was done by elbow fusion using fibular graft (n = 10), mobile endoprosthesis (n = 9), excision arthroplasty (n = 7), and extracorporeal freezing and reimplantation (n = 4). The mean follow-up period was 36.2 ± 21.3 months. The median follow-up MSTS score was 27 [Interquartile range (IQR): 26-30]. Skeletally immature patients had a significantly higher MSTS score. The rate of postoperative complications was 26.7%.

CONCLUSION

Limb salvage surgery with different reconstructive options for benign aggressive and malignant bone tumors around the elbow can achieve good functional and oncological outcomes.

LEVEL OF EVIDENCE

Level IV.

摘要

目的

肘部周围的骨肿瘤较为罕见，诊断常常延迟。本研究旨在评估保肢手术治疗肘部周围原发性良性侵袭性或恶性骨肿瘤的功能和肿瘤学结局。

方法

我们对1995年至2020年期间在单一肌肉骨骼肿瘤中心接受保肢手术治疗的肘部周围原发性侵袭性良性和恶性骨肿瘤患者进行了回顾性研究。最短随访期为24个月。在最后一次随访时使用肌肉骨骼肿瘤学会（MSTS）评分系统评估功能结果。记录局部复发、肺转移和并发症情况。

结果

本研究纳入30例患者，男性19例，女性11例，平均年龄25.4±14.2岁。肿瘤位于肱骨远端（n = 21）、桡骨近端（n = 5）和尺骨近端（n = 4）。采用腓骨移植肘关节融合术（n = 10）、可移动假体置换术（n = 9）、切除关节成形术（n = 7）和体外冷冻再植入术（n = 4）进行重建。平均随访期为36.2±21.3个月。随访时MSTS评分中位数为27[四分位间距（IQR）：26 - 30]。骨骼未成熟患者的MSTS评分显著更高。术后并发症发生率为26.7%。

结论

对于肘部周围良性侵袭性和恶性骨肿瘤采用不同重建方式的保肢手术可取得良好的功能和肿瘤学结局。

证据水平

IV级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/894acd1980ed/40634_2023_675_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/e85717afa47e/40634_2023_675_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/8802934a0952/40634_2023_675_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/894acd1980ed/40634_2023_675_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/e85717afa47e/40634_2023_675_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/8802934a0952/40634_2023_675_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/10593692/894acd1980ed/40634_2023_675_Fig3_HTML.jpg

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