Clinical effect of surgical resection on primary malignant and invasive bone tumours of the proximal fibula.

IF 1.4 Q4 ONCOLOGY Molecular and clinical oncology Pub Date : 2023-04-01 DOI:10.3892/mco.2023.2623
Feifei Pu, Yihan Yu, Zhicai Zhang, Jianxiang Liu, Zengwu Shao, Fengxia Chen, Jing Feng
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Abstract

There is no unified surgical plan for fibular proximal malignant tumours; therefore, the present study retrospectively analysed the medical records of 19 patients with primary malignant and invasive tumours in the proximal fibula and discussed the postoperative oncological results, complications and postoperative functions of limb salvage surgery. According to pathological classification, there were 10 osteosarcoma cases, 3 chondrosarcoma cases, 2 invasive giant cell osteosarcoma tumour cases, 1 epithelioid sarcoma case, 1 leiomyosarcoma case, 1 fibrosarcoma case and 1 lymphoma case. According to the Enneking instalment, IB stage was found in 2 cases, IIA in 2 cases and IIB in 15 cases. A total of 3 patients underwent Malawer I resection, and 16 patients underwent Malawer II resection. The follow-up period was 11-174 months, with an average of 76.58 months. Local recurrence occurred in three patients and distant metastasis in seven patients; 4 patients succumbed and 15 survived. After biceps femoris tendon reconstruction and lateral collateral ligament insertion, 18 patients had good knee stability. The Musculoskeletal Tumour Society scale ranged between 23 and 29 points, with an average of 27.26 points; the Lysholm Knee Score was 65-84 points, with an average of 83 points. After the resection of proximal fibula primary and invasive tumours, the biceps femoris tendon and lateral collateral ligament insertion point was reconstructed. The data show that this technique can effectively reconstruct stability and restore knee function.

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腓骨近端原发性恶性及侵袭性骨肿瘤手术切除的临床疗效。
腓骨近端恶性肿瘤没有统一的手术方案;因此,本研究回顾性分析了19例腓骨近端原发性恶性及侵袭性肿瘤患者的病历,并对保肢手术的术后肿瘤结果、并发症及术后功能进行了探讨。按病理分类,骨肉瘤10例,软骨肉瘤3例,侵袭性巨细胞骨肉瘤肿瘤2例,上皮样肉瘤1例,平滑肌肉瘤1例,纤维肉瘤1例,淋巴瘤1例。根据Enneking分期,IB期2例,IIA期2例,IIB期15例。Malawer I切除3例,Malawer II切除16例。随访11 ~ 174个月,平均76.58个月。局部复发3例,远处转移7例;死亡4例,存活15例。经股二头肌肌腱重建及外侧副韧带置入后,18例患者膝关节稳定性良好。肌肉骨骼肿瘤协会的评分范围在23到29分之间,平均27.26分;Lysholm膝关节评分为65-84分,平均为83分。切除腓骨近端原发性及侵袭性肿瘤后,重建股二头肌肌腱及外侧副韧带止点。结果表明,该技术能有效地重建膝关节稳定性,恢复膝关节功能。
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