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骨巨细胞瘤切除术后尺骨远端重建的手术技术

OPERATIVE TECHNIQUE FOR RECONSTRUCTION OF DISTAL ULNA AFTER GIANT CELL TUMOUR RESECTION.

作者信息

Starčević Katarina Barbarić, Bohaček Ivan

机构信息

Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.

School of Medicine and Department of Orthopaedic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2023 Aug;62(Suppl3):77-82. doi: 10.20471/acc.2023.62.s3.10.

Abstract

Giant cell tumour (GCT) is a rare, benign tumour, but it has a locally aggressive nature and a high rate of recurrence. A wide en-bloc resection of the distal part of the ulna, with or without stabilisation of the ulnar stump, is the recommended treatment option. Functional results after that kind of surgery are mostly satisfying but, in some cases, it can result in wrist instability, causing pain and weakness of grip strength. That is why when it comes to young people, with high functional demands, we prefer reconstruction of distal ulna and distal radioulnar joint after an en-bloc resection of the distal ulna. The distal ulna is reconstructed with an autologous free fibular graft and the distal radioulnar joint is stabilised with an autologous palmaris longus tendon graft. We present our operative technique and good functional results of three young patients treated with this procedure. Our results confirm the hypothesis that the reconstruction of the distal ulna and the distal radioulnar joint leads to a satisfactory functional result in young and active patients with higher functional demands.

摘要

骨巨细胞瘤(GCT)是一种罕见的良性肿瘤,但具有局部侵袭性且复发率高。推荐的治疗方案是对尺骨远端进行广泛整块切除,可选择保留或不保留尺骨残端的稳定。这类手术后的功能结果大多令人满意,但在某些情况下,可能导致腕关节不稳定,引起疼痛和握力减弱。这就是为什么对于功能需求较高的年轻人,我们更倾向于在尺骨远端整块切除后重建尺骨远端和桡尺远侧关节。使用自体游离腓骨移植重建尺骨远端,并用自体掌长肌腱移植稳定桡尺远侧关节。我们展示了采用该手术方法治疗的3例年轻患者的手术技术和良好功能结果。我们的结果证实了这样一个假设,即对于功能需求较高的年轻活跃患者,重建尺骨远端和桡尺远侧关节可带来令人满意的功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fb1/12054447/b3b4e79427ac/acc-62_supp3-77-f1.jpg

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