Induced membrane technique for malignant bone tumours of the humerus

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2024-09-12 DOI:10.1007/s00264-024-06313-2

Tristan Langlais, Coline Ducrot, Pierre Mary, Raphael Vialle, Pierre-Alban Bouche, Malo Le Hanneur, Franck Fitoussi

{"title":"Induced membrane technique for malignant bone tumours of the humerus","authors":"Tristan Langlais, Coline Ducrot, Pierre Mary, Raphael Vialle, Pierre-Alban Bouche, Malo Le Hanneur, Franck Fitoussi","doi":"10.1007/s00264-024-06313-2","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>The aim of this study was to report on mid- to long-term results following large humeral tumoral resection and reconstruction with the induced-membrane technique in skeletally immature patients suffering from primary malignant bone tumours.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A retrospective analysis identified all children who underwent the two stages of a humeral reconstruction using the induced-membrane technique for primary malignant humerus tumours between 2002 and 2020. Functional assessment was conducted by an independent observer using the Musculoskeletal Tumor Society (MSTS) scoring system for the upper limb. Radiological assessment was performed by two independent observers and the healing index was calculated (i.e., months/cm).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Eight adolescents (5 osteosarcomas and 3 Ewing sarcoma), with a mean age of 14.2 years (SD = 2.7), were included. The mean length of the bone resection was 17.4 cm (SD = 3.8), and the mean delay of the resection and reconstruction stages was 9.4 months (SD = 4). The mean follow-up was 6.6 years (SD = 4.3). The mean MSTS score was 77.4% and the global average healing index was 1.04 months/cm (SD = 2.2). Four complications (i.e., prominence device, fracture, aseptic pseudarthrosis, radial palsy) and one local recurrence were observed in four patients, requiring four unplanned surgical procedures in three patients. One patient died fourteen years after the initial treatment due to a lung recurrence.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The induced-membrane technique is an effective and safe alternative for reconstructing large humeral bone defects after tumour resection in adolescents. Although this is a two-stage technique, it gives good functional results comparable to other strategies found in the literature.</p><h3 data-test=\"abstract-sub-heading\">Level of evidence</h3><p>IV.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":"12 1","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-024-06313-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

The aim of this study was to report on mid- to long-term results following large humeral tumoral resection and reconstruction with the induced-membrane technique in skeletally immature patients suffering from primary malignant bone tumours.

Methods

A retrospective analysis identified all children who underwent the two stages of a humeral reconstruction using the induced-membrane technique for primary malignant humerus tumours between 2002 and 2020. Functional assessment was conducted by an independent observer using the Musculoskeletal Tumor Society (MSTS) scoring system for the upper limb. Radiological assessment was performed by two independent observers and the healing index was calculated (i.e., months/cm).

Results

Eight adolescents (5 osteosarcomas and 3 Ewing sarcoma), with a mean age of 14.2 years (SD = 2.7), were included. The mean length of the bone resection was 17.4 cm (SD = 3.8), and the mean delay of the resection and reconstruction stages was 9.4 months (SD = 4). The mean follow-up was 6.6 years (SD = 4.3). The mean MSTS score was 77.4% and the global average healing index was 1.04 months/cm (SD = 2.2). Four complications (i.e., prominence device, fracture, aseptic pseudarthrosis, radial palsy) and one local recurrence were observed in four patients, requiring four unplanned surgical procedures in three patients. One patient died fourteen years after the initial treatment due to a lung recurrence.

Conclusion

The induced-membrane technique is an effective and safe alternative for reconstructing large humeral bone defects after tumour resection in adolescents. Although this is a two-stage technique, it gives good functional results comparable to other strategies found in the literature.

Level of evidence

IV.

Abstract Image

查看原文本刊更多论文

治疗肱骨恶性骨肿瘤的诱导膜技术

目的本研究旨在报告骨骼尚未发育成熟的原发性恶性骨肿瘤患者采用诱导膜技术进行肱骨大肿瘤切除和重建后的中长期效果。方法通过回顾性分析，确定了2002年至2020年间采用诱导膜技术对原发性恶性肱骨肿瘤进行两阶段肱骨重建的所有儿童。功能评估由一名独立观察员使用肌肉骨骼肿瘤协会（MSTS）上肢评分系统进行。由两名独立观察者进行放射学评估，并计算愈合指数（即月/厘米）。结果共纳入八名青少年（5 名骨肉瘤患者和 3 名尤文肉瘤患者），平均年龄为 14.2 岁（SD = 2.7）。骨切除术的平均长度为17.4厘米（SD = 3.8），切除和重建阶段的平均延迟时间为9.4个月（SD = 4）。平均随访时间为 6.6 年（SD = 4.3）。MSTS平均得分率为77.4%，总体平均愈合指数为1.04个月/厘米（SD = 2.2）。四名患者出现了四次并发症（即突出装置、骨折、无菌性假关节、桡骨麻痹）和一次局部复发，三名患者需要进行四次计划外手术。结论诱导膜技术是重建青少年肿瘤切除术后大块肱骨骨缺损的一种有效而安全的替代方法。虽然这是一种两阶段技术，但其功能效果良好，可与文献中发现的其他策略相媲美。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.