定制人工肱骨头假体置换治疗肱骨近端骨肿瘤的疗效_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

陈志伟 , 邓焱 , 侯子鑫 , 廖瑛 , 范伟杰

Corresponding author：

Keywords：

肱骨近端骨肿瘤; 定制人工肱骨头假体; 关节置换

DOI：

10.7507/1002-1892.20130116

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目的总结定制人工肱骨头假体置换治疗肱骨近端骨肿瘤的临床疗效。方法2005年1月－2011年10月，对16例肱骨近端骨肿瘤患者行瘤段切除及定制人工肱骨头假体置换治疗。男10例，女6例；年龄14～68岁，平均25.5岁。皮质旁骨肉瘤2例，软骨肉瘤2例，转移性平滑肌肉瘤1例，尤文肉瘤2例；根据Enneking分期：Ⅰb期4 例，Ⅱb期3例。侵袭性和复发性骨巨细胞瘤各3例，骨巨细胞瘤合并动脉瘤样骨囊肿3例；根据Campanicci分级：Ⅲ级7例，Ⅰ～Ⅱ级2例。病程2～28个月，平均11.6个月。除骨巨细胞瘤患者外均辅助给予术前1～2 个疗程、术后2～3个疗程正规化疗。结果术后患者切口均Ⅰ期愈合，无感染等并发症发生。患者均获随访，随访时间12～81个月，平均38.6个月。X线片检查示，随访期间无假体感染、松动、断裂及假体周围骨折等并发症发生。术后12个月，肩关节功能采用肌肉骨骼肿瘤学会评分标准为16～29分，平均24.1分；获优11例，良3例，中2例，优良率达87.5%。1 例尤文肉瘤患者于术后22个月死于肺转移；1例骨巨细胞瘤患者于术后2年复发；其余患者均无肿瘤复发。结论应用定制人工肱骨头假体置换治疗肱骨近端骨肿瘤能降低术后并发症，且肩关节功能恢复满意。

Citation： 陈志伟,邓焱,侯子鑫,廖瑛,范伟杰. 定制人工肱骨头假体置换治疗肱骨近端骨肿瘤的疗效. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(4): 511-512. doi: 10.7507/1002-1892.20130116 Copy

1.	Torbert JT, Fox EJ, Hosalkar HS, et al. Endoprosthetic reconstructions: results of long-term followup of 139 patients. Clin Orthop Relat Res, 2005, (438): 51-59.
2.	Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res, 1993, (286): 241-246.
3.	van de Sande MAJ, Dijkstra S, Taminiau AHM. Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop, 2011, 35(9): 1375-1380.
4.	Raiss P, Kinkel S, Sauter U, et al. Replacement of the proximal humerus with MUTARS tumor endoprostheses. Eur J Surg Oncol, 2010, 36(4): 371-377.
5.	郭世炳, 冯卫, 贾燕飞. 特制假体置换在邻关节骨巨细胞瘤治疗中的应用. 中国修复重建外科杂志, 2008, 22(1): 120-122.
6.	Fuhrmann RA, Roth A, Venbrocks RA. Salvage of the upper extremity in cases of tumorous destruction of the proximal humerus. J Cancer Res Clin Oncol, 2000, 126(6): 337-344.
7.	Cannon CP, Paraliticci GU, Lin PP, et al. Functional outcome following endoprosthetic reconstruction of the proximal humerus. J Shoulder Elbow Surg, 2009, 18(5): 705-710.

1. Torbert JT, Fox EJ, Hosalkar HS, et al. Endoprosthetic reconstructions: results of long-term followup of 139 patients. Clin Orthop Relat Res, 2005, (438): 51-59.
2. Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res, 1993, (286): 241-246.
3. van de Sande MAJ, Dijkstra S, Taminiau AHM. Proximal humerus reconstruction after tumour resection: biological versus endoprosthetic reconstruction. Int Orthop, 2011, 35(9): 1375-1380.
4. Raiss P, Kinkel S, Sauter U, et al. Replacement of the proximal humerus with MUTARS tumor endoprostheses. Eur J Surg Oncol, 2010, 36(4): 371-377.
5. 郭世炳, 冯卫, 贾燕飞. 特制假体置换在邻关节骨巨细胞瘤治疗中的应用. 中国修复重建外科杂志, 2008, 22(1): 120-122.
6. Fuhrmann RA, Roth A, Venbrocks RA. Salvage of the upper extremity in cases of tumorous destruction of the proximal humerus. J Cancer Res Clin Oncol, 2000, 126(6): 337-344.
7. Cannon CP, Paraliticci GU, Lin PP, et al. Functional outcome following endoprosthetic reconstruction of the proximal humerus. J Shoulder Elbow Surg, 2009, 18(5): 705-710.

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Chinese Journal of Reparative and Reconstructive Surgery

定制人工肱骨头假体置换治疗肱骨近端骨肿瘤的疗效

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