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刮除术后使用碳纤维板固定治疗良性及局部侵袭性骨肿瘤:临床及影像学结果

Fixation with Carbon Fiber Plates After Curettage in Benign and Locally Aggressive Bone Tumors: Clinical and Radiographic Outcomes.

作者信息

Ipponi Edoardo, Bechini Elena, Bettarini Vittoria, Cordoni Martina, Gentili Fabrizia, D'Arienzo Antonio, Parchi Paolo Domenico, Andreani Lorenzo

机构信息

Department of Orthopedics and Trauma Surgery, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy.

出版信息

J Clin Med. 2025 Mar 29;14(7):2371. doi: 10.3390/jcm14072371.

Abstract

: Curettage represents a reliable therapeutic option for large-sized benign and locally aggressive bone tumors. In cases of impending fractures, internal fixation with plates and screws can be necessary to stabilize the treated bone after curettage. Metal plates have been the only fixation devices available on the market for decades, but Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) now represents an alternative in orthopedic oncology. : We reviewed our patients with benign or locally aggressive bone tumors treated with curettage and fixation with CFR-PEEK plates. Plate length and curettage technique were chosen considering the characteristics of each lesion. We recorded the size and location of the lesions, adjuvant treatments and fillers used after curettage, complications, and local recurrences. Postoperative functionality was assessed using the MSTS score. : Forty cases were included in our study. The tumors were located in the distal femur (19 cases), femur shaft (1), humerus (17), or proximal tibia (3). Local adjuvants were used in 20 cases. Cavities were filled with bone allografts in 30 cases and cement in 10 cases. Only four cases suffered postoperative complications, and two developed local recurrences. The mean postoperative follow-up was 29.2 months. The mean postoperative upper and lower limb MSTS was 28.0 and 26.7, respectively. : After an accurate curettage and an adequate filling of the resulting bone gap, CFR-PEEK plates can provide good mechanical resistance, and their radio-transparency can ease the early diagnosis of local recurrences. CFR-PEEK plates should be considered in selected cases, in a personalized surgical approach.

摘要

刮除术是治疗大型良性及局部侵袭性骨肿瘤的可靠治疗选择。对于有骨折风险的病例,刮除术后可能需要使用钢板和螺钉进行内固定以稳定治疗后的骨骼。几十年来,金属板一直是市场上唯一可用的固定装置,但碳纤维增强聚醚醚酮(CFR-PEEK)现在已成为骨肿瘤整形外科的一种替代选择。:我们回顾了接受刮除术并用CFR-PEEK板固定治疗的良性或局部侵袭性骨肿瘤患者。根据每个病变的特征选择钢板长度和刮除技术。我们记录了病变的大小和位置、刮除术后使用的辅助治疗和填充物、并发症以及局部复发情况。使用肌肉骨骼肿瘤学会(MSTS)评分评估术后功能。:我们的研究纳入了40例病例。肿瘤位于股骨远端(19例)、股骨干(1例)、肱骨(17例)或胫骨近端(3例)。20例使用了局部辅助剂。30例用同种异体骨填充骨腔,10例用骨水泥填充。只有4例出现术后并发症,2例发生局部复发。术后平均随访29.2个月。术后上肢和下肢MSTS评分的平均值分别为28.0和26.7。:在进行精确的刮除术并充分填充形成的骨缺损后,CFR-PEEK板可提供良好的机械抗力,其射线可透性有助于早期诊断局部复发。在个性化的手术方法中,对于选定的病例应考虑使用CFR-PEEK板。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221b/11989884/22f970cf615c/jcm-14-02371-g001.jpg

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