Rachbauer Anna Maria, Schneider Kristian Nikolaus, Gosheger Georg, Deventer Niklas
Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, 48149 Muenster, Germany.
Cancers (Basel). 2023 Nov 8;15(22):5330. doi: 10.3390/cancers15225330.
Reconstructing the proximal humerus after tumor removal is challenging due to muscle and bone loss. The current methods often result in poor shoulder function. This study assessed the long-term functional and oncological outcomes of using an inverse proximal humerus prosthesis in 46 patients with bone tumors. The results showed a mean range of motion of 62° in anteversion, 28° in retroversion, and 55° in abduction. Notably, 23 patients achieved over 90° of shoulder abduction, with an average of 140°. The median Musculoskeletal Tumor Society Score was 25. Complications included infection in two radiotherapy patients and single dislocations in seven patients. One patient with recurrent dislocations needed revision surgery. In conclusion, the use of the inverse proximal humerus prosthesis in bone tumor treatment yields excellent shoulder function and high patient satisfaction. This approach is especially beneficial for those with metastatic disease.
由于肌肉和骨质缺失,肿瘤切除后肱骨近端的重建具有挑战性。目前的方法常常导致肩部功能不佳。本研究评估了46例骨肿瘤患者使用肱骨近端反置假体的长期功能和肿瘤学结局。结果显示,前屈平均活动范围为62°,后伸为28°,外展为55°。值得注意的是,23例患者肩部外展超过90°,平均为140°。肌肉骨骼肿瘤学会评分中位数为25分。并发症包括2例放疗患者发生感染,7例患者出现单次脱位。1例反复脱位的患者需要进行翻修手术。总之,在骨肿瘤治疗中使用肱骨近端反置假体可产生优异的肩部功能和较高的患者满意度。这种方法对患有转移性疾病的患者尤其有益。