Reconstruction Strategy for Upper Extremity Defects After Bone Tumor Resection Based on 3D Customized Bone Cement Mold

IF 1.2 4区 医学 Q3 SURGERY
Song Ke, Bokai Zhang, Yongqin He, Yuanyuan Zhou, Xu Hu, Yubo Fan, Min Wang, Yuan Zhang, Chao Wang
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Abstract

BackgroundReconstructing bone defects in the upper extremities and restoring their functions poses a significant challenge. In this study, we describe a novel workflow for designing and manufacturing customized bone cement molds using 3D printing technology to reconstruct upper extremity defects after bone tumor resection.MethodsComputer tomography data was acquired from the unaffected upper extremities to create a detachable mold, which can be customized to fit the joint precisely by shaping the bone cement accordingly. Fourteen patients who underwent reconstructive surgery following bone tumor resection in the proximal humerus (13 cases) or distal radius (1 case) between January 2014 and December 2022 were retrospectively evaluated. The medical records of this case series were reviewed for the demographic, radiological, and operative data. Metastasis, local recurrence, and complication were also reviewed. Additionally, Musculoskeletal Tumor Society Score (MSTS) and Visual Analogue Scale (VAS) were used to assess clinical outcomes.ResultsThe mean follow-up period was 49.36 ± 15.18 months (range, 27-82 months). At the end of follow-up, there were no cases of metastasis or recurrence, and patients did not experience complications such as infection, dislocation, or implant loosening. Two cases complicated with subluxation (14.3%), and 1 case underwent revision surgery for prosthetic fracture (7.1%). The average MSTS score was 23.2 ± 1.76 (77.4%, range, 66.7%-86.7%), and the postoperative VAS score was 1.86 ± 1.03 (range, 1-4), which was significantly lower than that before surgery (average preoperative VAS score was 5.21 ± 2.00 (range, 2-8)) ( P < .001).ConclusionCustomized 3D molds can be utilized to shape bone cement prostheses, which may serve as a potential alternative for reconstructing the proximal humerus and distal radius following en bloc resection of bone tumors. This reconstruction strategy offers apparent advantages, including precise matching of articular surfaces and comparatively reduced costs.
基于三维定制骨水泥模型的骨肿瘤切除术后上肢缺损重建策略
背景重建上肢骨缺损并恢复其功能是一项重大挑战。在这项研究中,我们介绍了一种利用 3D 打印技术设计和制造定制骨水泥模具的新型工作流程,以重建骨肿瘤切除术后的上肢缺损。方法从未受损伤的上肢获取计算机断层扫描数据,以创建可拆卸的模具,该模具可通过相应的骨水泥塑形进行定制,以精确地适合关节。研究人员对2014年1月至2022年12月期间接受肱骨近端(13例)或桡骨远端(1例)骨肿瘤切除后重建手术的14例患者进行了回顾性评估。对该系列病例的病历进行了审查,以了解人口统计学、放射学和手术数据。此外,还审查了转移、局部复发和并发症。结果平均随访时间为(49.36 ± 15.18)个月(27-82 个月)。随访结束时,无转移或复发病例,患者未出现感染、脱位或种植体松动等并发症。2例患者并发了半脱位(14.3%),1例患者因假体骨折接受了翻修手术(7.1%)。平均 MSTS 评分为 23.2 ± 1.76(77.4%,范围为 66.7%-86.7%),术后 VAS 评分为 1.86 ± 1.03(范围为 1-4),明显低于术前(术前平均 VAS 评分为 5.21 ± 2.结论定制的三维模具可用于塑造骨水泥假体,这可能成为骨肿瘤整体切除术后重建肱骨近端和桡骨远端的潜在替代方案。这种重建策略具有明显的优势,包括关节面的精确匹配和相对较低的成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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