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Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results

机译:四肢保留术治疗肩带骨肿瘤:肿瘤学和功能结果

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摘要

It is a great challenge to spare the upper limb with a malignant or invasive benign bone tumour of the shoulder girdle. We retrospectively analysed 35 patients with bone tumours of the shoulder girdle treated with various limb salvage procedures. The tumours included 25 primary malignancies, three metastases and seven giant cell tumours which involved the proximal humerus in 21 patients, scapula in 12 and clavicle in two. The reconstruction procedures included eight prosthetic replacements, four devitalised tumorous bone grafts, three osteoarticular allografts, two autogenous fibular grafts, one intramedullary cemented nail, three Tikhoff-Linberg procedures, two replantation of shortened arms, and four humeral head suspensions. Six partial scapulectomies and two lateral clavicectomies needed no bone reconstruction. With an average follow-up of 71 months, local recurrences occurred in four cases and systemic metastases in six. Nine patients died and 23 remained disease free. The five year Kaplan-Meier survival rate of 28 patients with malignancies was 69.5%. The average Musculoskeletal Tumour Society (MSTS) functional score was 77% (range 40–100%) in all patients.
机译:要为上肢保留肩带的恶性或浸润性良性骨肿瘤是一个巨大的挑战。我们回顾性分析了采用各种肢体挽救方法治疗的35例肩带骨肿瘤患者。肿瘤包括25例原发性恶性肿瘤,3处转移瘤和7例巨细胞瘤,其中21例累及肱骨近端,12例肩骨,2例锁骨。重建过程包括八次假体置换,四次失活的肿瘤性骨移植,三次骨关节同种异体移植,两个自体腓骨移植,一枚髓内骨水泥钉,三个Tikhoff-Linberg手术,两次短臂再植和四个肱骨头悬吊术。六个部分的肩骨切开术和两个侧面的剖腹术不需要骨重建。平均随访71个月,4例发生局部复发,6例发生全身转移。 9名患者死亡,23名患者无病。 28例恶性肿瘤患者的5年Kaplan-Meier存活率为69.5%。在所有患者中,肌肉骨骼肿瘤协会(MSTS)的平均功能评分为77%(范围40-100%)。

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