Innovative approaches to cage reconstructions in orthopedic limb surgery: Advances and insights with two cases

Halil Ibrahim BULUT , Erhan OKAY , Tolga ONAY , Enes KANAY , Korhan OZKAN
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Abstract

Background

Limb tumors, though rare, pose significant challenges to surgical management due to their impact on limb function and quality of life. Effective treatment requires precise tumor resection alongside advanced reconstructive techniques to restore limb function, particularly in cases of compromised bone healing. Titanium cages, traditionally used in spinal surgeries, have recently gained attention for their potential in limb reconstruction within orthopedic oncology, offering a novel approach to managing complex bone defects.

Case Presentation

This retrospective case series presents two patients treated with titanium cages for limb reconstruction following tumor resection.
Case 1: A 53-year-old female with a solitary plasmacytoma of the femur experienced a pathological fracture and nonunion after initial treatment. A titanium cage was employed to bridge the resected bone segment, leading to successful callus formation at the six-month follow-up and restored limb function.
Case 2: A 31-year-old female with a giant cell tumor and hemangioma of the foot underwent en bloc resection followed by reconstruction using a vertebral cage and iliac corticospongious graft. Six months postoperatively, the patient had resumed full weight-bearing with no complications.

Conclusion

Titanium cages offer a promising solution for limb reconstruction in patients with tumors, particularly for large bone defects where traditional methods may be inadequate. This case series demonstrates successful outcomes in limb preservation and functional recovery using titanium cages. Their use in the adult population shows potential for broader application in orthopedic oncology, warranting further clinical investigation.
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矫形肢体手术中笼重建的创新方法:两个病例的进展和启示
背景肢体肿瘤虽然罕见,但由于其对肢体功能和生活质量的影响,给手术治疗带来了巨大挑战。有效的治疗需要在精确切除肿瘤的同时采用先进的重建技术来恢复肢体功能,尤其是在骨愈合受损的情况下。钛笼传统上用于脊柱手术,最近因其在肿瘤骨科肢体重建中的潜力而备受关注,为处理复杂的骨缺损提供了一种新方法。本回顾性病例系列介绍了两名在肿瘤切除术后使用钛笼进行肢体重建的患者。病例 1:一名 53 岁的女性,患有股骨单发浆细胞瘤,在初次治疗后出现病理性骨折和不愈合。病例 2:一名 31 岁的女性患者,患有足部巨细胞瘤和血管瘤,在接受全切手术后,使用椎体骨架和髂骨皮质海绵移植进行了重建。结论钛笼为肿瘤患者的肢体重建提供了一种前景广阔的解决方案,特别是对于传统方法可能无法解决的大块骨缺损。本系列病例展示了使用钛笼在肢体保留和功能恢复方面的成功结果。在成年人群中使用钛笼显示出在肿瘤骨科中更广泛应用的潜力,值得进一步临床研究。
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