病例报告:用于盂状肿瘤重建的定制 3D 植入物应设计为反向全肩关节成形术。

IF 1.6 4区 医学 Q2 SURGERY Frontiers in Surgery Pub Date : 2024-10-16 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1433692
Robin Evrard, Antoine Ledoux, Pierre-Louis Docquier, Florine Geenens, Thomas Schubert
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引用次数: 0

摘要

背景和目的:盂骨的孤立性骨肿瘤极为罕见,是一项巨大的手术挑战。3D 打印技术已被证明是重建骨骼复杂解剖部位的可靠工具。我们最初使用该技术以半关节成形术的方式重建肩关节盂部件。随后,我们改用反向肩关节成形术:方法:两名患者采用半关节成形术重建,两名患者采用反向结构重建。结果:平均随访时间为(36.44±2)年,随访时间为(36.44±2)小时:平均随访时间为(36.44 ± 16.27)个月。结果:平均随访时间为(36.44 ± 16.27)个月,所有患者均健在且无疾病。从半关节成形术中获益的两名患者的肱骨近端关节面迅速恶化。鉴于他们的疼痛和功能评分,他们随后需要进行翻修,以进行全肩关节成形术。手术后,一名患者出现肩关节脱位,需要再次手术治疗。在这个短期系列中,我们没有观察到任何松动或感染:鉴于肱骨近端受到机械限制,且手术范围必然会损伤肩胛上神经血管束,因此定制盂成形术应设计为反向肩关节成形术。
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Case Report: Custom made 3D implants for glenoid tumor reconstruction should be designed as reverse total shoulder arthroplasty.

Background and objectives: Isolated bone tumors of the glenoid are exceedingly rare occurrence and pose a substantial surgical challenge. 3D printing technology has been proved to be a reliable tool to reconstruct complex anatomical part of the skeleton. We initially used this technology to reconstruct the glenoid component of the shoulder in a hemiarthroplasty configuration. We subsequently changed to a reverse shoulder arthroplasty.

Methods: Two patients were reconstructed with a hemiarthroplasty and 2 with a reverse configuration. Patients files were reviewed for radiographic analysis, pain and function scores.

Results: Mean follow-up was 36.44 ± 16.27 months. All patients are alive and disease free. The two patients who benefitted from a hemiarthroplasty demonstrated a rapid deterioration of the proximal humeral articular surface. Given their pain and function scores, they subsequently required revision towards a total shoulder arthroplasty. Following this conversion, one patient presented a shoulder dislocation requiring surgical reintervention. We did not observe any loosening or infection in this short series.

Conclusions: Custom made glenoid reconstruction should be designed as a reverse shoulder arthroplasty given the mechanical constrains on the proximal humerus and the extent of the surgery invariably damaging the suprascapular neurovascular bundle.

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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
期刊介绍: Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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