Diego Perez DA Motta, Beatriz Gomes Arruda, Rafael DE Castro E Silva Pinheiro, Gabriel Araújo Ribeiro, Bruna Canteri Delocco, Bruno DE Oliveira Fiorelli, Eduardo Alessandro Lima Witte, Walter Meohas
{"title":"踝关节肿瘤切除及异体移植重建。","authors":"Diego Perez DA Motta, Beatriz Gomes Arruda, Rafael DE Castro E Silva Pinheiro, Gabriel Araújo Ribeiro, Bruna Canteri Delocco, Bruno DE Oliveira Fiorelli, Eduardo Alessandro Lima Witte, Walter Meohas","doi":"10.1590/1413-785220233105e266018","DOIUrl":null,"url":null,"abstract":"<p><p>Reconstruction of the distal third of the tibia due to resection of a malignant tumor has some hindering factors, such as a thin subcutaneous layer, neurovascular bundles that cross compartments, prolonged operative duration, specific orthopedic material, and a trained multidisciplinary team. Allografting with material from tissue banks is part of this orthopaedic arsenal.</p><p><strong>Objective: </strong>To describe the protocol used at Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad.</p><p><strong>Methods: </strong>Series of six cases subjected to resection with oncologic margins, allograft reconstruction, and use of a retrograde ankle nail as limb-salvage surgery. Three of the six patients were women, the lesions were on average 9.3 cm long, and the average operative duration was 3.25 hours.</p><p><strong>Results: </strong>The main short-term complication (≤ 30 days) was peroneal nerve palsy, while the main long-term complication (> 30 days) was surgical site infection (two cases). Consolidation of the two foci occurred in three patients, and two patients developed asymptomatic pseudoarthrosis of the proximal focus with consolidation of the distal focus.</p><p><strong>Conclusion: </strong>Despite the complications, the proposed surgery gives patients the chance to preserve their limb in the face of immediate radical surgery. <i>Level of Evidence IV, Case Series</i>.</p>","PeriodicalId":55563,"journal":{"name":"Acta Ortopedica Brasileira","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592342/pdf/","citationCount":"0","resultStr":"{\"title\":\"RESECTION OF ANKLE TUMOR LESION AND RECONSTRUCTION WITH THE USE OF ALLOGRAFT.\",\"authors\":\"Diego Perez DA Motta, Beatriz Gomes Arruda, Rafael DE Castro E Silva Pinheiro, Gabriel Araújo Ribeiro, Bruna Canteri Delocco, Bruno DE Oliveira Fiorelli, Eduardo Alessandro Lima Witte, Walter Meohas\",\"doi\":\"10.1590/1413-785220233105e266018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Reconstruction of the distal third of the tibia due to resection of a malignant tumor has some hindering factors, such as a thin subcutaneous layer, neurovascular bundles that cross compartments, prolonged operative duration, specific orthopedic material, and a trained multidisciplinary team. Allografting with material from tissue banks is part of this orthopaedic arsenal.</p><p><strong>Objective: </strong>To describe the protocol used at Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad.</p><p><strong>Methods: </strong>Series of six cases subjected to resection with oncologic margins, allograft reconstruction, and use of a retrograde ankle nail as limb-salvage surgery. Three of the six patients were women, the lesions were on average 9.3 cm long, and the average operative duration was 3.25 hours.</p><p><strong>Results: </strong>The main short-term complication (≤ 30 days) was peroneal nerve palsy, while the main long-term complication (> 30 days) was surgical site infection (two cases). Consolidation of the two foci occurred in three patients, and two patients developed asymptomatic pseudoarthrosis of the proximal focus with consolidation of the distal focus.</p><p><strong>Conclusion: </strong>Despite the complications, the proposed surgery gives patients the chance to preserve their limb in the face of immediate radical surgery. <i>Level of Evidence IV, Case Series</i>.</p>\",\"PeriodicalId\":55563,\"journal\":{\"name\":\"Acta Ortopedica Brasileira\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2023-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10592342/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Ortopedica Brasileira\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/1413-785220233105e266018\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Ortopedica Brasileira","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1413-785220233105e266018","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
RESECTION OF ANKLE TUMOR LESION AND RECONSTRUCTION WITH THE USE OF ALLOGRAFT.
Reconstruction of the distal third of the tibia due to resection of a malignant tumor has some hindering factors, such as a thin subcutaneous layer, neurovascular bundles that cross compartments, prolonged operative duration, specific orthopedic material, and a trained multidisciplinary team. Allografting with material from tissue banks is part of this orthopaedic arsenal.
Objective: To describe the protocol used at Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad.
Methods: Series of six cases subjected to resection with oncologic margins, allograft reconstruction, and use of a retrograde ankle nail as limb-salvage surgery. Three of the six patients were women, the lesions were on average 9.3 cm long, and the average operative duration was 3.25 hours.
Results: The main short-term complication (≤ 30 days) was peroneal nerve palsy, while the main long-term complication (> 30 days) was surgical site infection (two cases). Consolidation of the two foci occurred in three patients, and two patients developed asymptomatic pseudoarthrosis of the proximal focus with consolidation of the distal focus.
Conclusion: Despite the complications, the proposed surgery gives patients the chance to preserve their limb in the face of immediate radical surgery. Level of Evidence IV, Case Series.
期刊介绍:
A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.