踝关节肿瘤切除及异体移植重建。

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Acta Ortopedica Brasileira Pub Date : 2023-10-23 eCollection Date: 2023-01-01 DOI:10.1590/1413-785220233105e266018
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
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引用次数: 0

摘要

由于恶性肿瘤切除而重建胫骨远端三分之一有一些阻碍因素,如皮下薄层、交叉隔室的神经血管束、手术时间延长、特定的骨科材料和训练有素的多学科团队。用组织库中的材料进行同种异体移植是这个整形外科武器库的一部分。目的:描述Jamil Haddad国家创伤研究所使用的方案。方法:对6例患者进行肿瘤切缘切除、同种异体移植物重建和使用逆行踝钉作为保肢手术。六名患者中有三名是女性,病变平均长9.3厘米,平均手术时间为3.25小时。结果:近期并发症(≤30天)以腓神经麻痹为主,远期并发症(>30天)以手术部位感染为主(2例)。三名患者出现两个病灶合并,两名患者出现无症状的近端病灶合并远端病灶的假关节病。结论:尽管存在并发症,但拟议的手术为患者提供了在面临立即根治性手术时保留肢体的机会。证据等级IV,案例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

RESECTION OF ANKLE TUMOR LESION AND RECONSTRUCTION WITH THE USE OF ALLOGRAFT.

RESECTION OF ANKLE TUMOR LESION AND RECONSTRUCTION WITH THE USE OF ALLOGRAFT.

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.

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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
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.
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