Reconstruction with scapular hemiarthroplasty endoprosthesis after scapulectomy for malignant tumour

被引:11
作者
Min, Li [1 ,2 ,3 ]
Zhou, Yong [1 ]
Tang, Fan [1 ,2 ,3 ]
Zhang, Wenli [1 ]
Luo, Yi [1 ]
Duan, Hong [1 ]
Tu, Chongqi [1 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Orthoped, Guoxue Xiang 37, Chengdu 610041, Sichuan, Peoples R China
[2] Massachusetts Gen Hosp, Dept Orthopaed Surg, Sarcoma Biol Lab, 55 Fruit St,Jackson 1115, Boston, MA 02114 USA
[3] Harvard Med Sch, 55 Fruit St,Jackson 1115, Boston, MA 02114 USA
关键词
Scapula; Oncology; Limb salvage; Scapulectomy; Endoprosthesis; ALLOGRAFT RECONSTRUCTION; SURGICAL TECHNIQUE; RESECTION; BONE; SYSTEM;
D O I
10.1007/s00264-017-3429-y
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
100224 [整形外科学];
摘要
Purpose Recently, endoprosthesis reconstruction has been used for scapular malignant tumours. Our aim is to present and evaluate the clinical indications, peri-operative technique, and mid-term clinical results. Methods Scapular hemiarthroplasty after total scapulectomy has been performed in 15 patients between 2011 and 2014. Clinical records and radiographs were evaluated retrospectively. Results The average follow-up was 41.2 months. No infection, dislocation, pressure ulcer, wound healing problems or mechanical failures were reported. Three patients died due to lung metastasis. The final follow-up average Musculoskeletal Tumor Society (MSTS) scoring system score was 25.3 points. The average ranges of motion of shoulder abduction and forward flexion were 45.3A degrees and 65.7A degrees, respectively. There were significant differences in function, lifting ability, MSTS scores, abduction function and flexion function between the seven patients with artificial ligament reconstruction for articular capsule and the others with direct suture. Three patients who had reconstruction of the rotator cuff were verified to gain better post-operative hand positioning, lifting ability, MSTS score, and abduction function than the others without rotator cuff reconstruction. Conclusions As long as the indications and surgical skills are fully mastered, reconstruction with the scapular hemiarthroplasty endoprosthesis can result in mid-term oncologic salvage, good post-operative function and low complication rate after scapulectomy for malignant tumors.
引用
收藏
页码:1057 / 1063
页数:7
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