CAJ | 학술논문

目的：探讨肱骨近端骨肿瘤切除后人工假体重建肩关节的功能的临床效果。方法对18例肱骨近端骨肿瘤患者采用肿瘤型肱骨近端假体重建肩关节，肿瘤类型：骨肉瘤6例，软骨肉瘤4例，浆细胞瘤1例，恶性骨巨细胞瘤4例，转移癌3例。骨肉瘤、浆细胞瘤患者手术前后均接受化疗。术后6个月采用MSTS功能评分系统评价术后肩关节功能。结果1例失访，17例获随访，时间10～96（52.8±8.4）个月。死亡4例，复发1例，肩关节半脱位2例。肩关节MSTS功能评分为9～27（18．6±3．5）分，其中优8例，良5例，中2例，差2例，优良率13/17。结论应用肿瘤型肱骨近端假体治疗肱骨上段肿瘤能降低术后并发症，需注意肩袖和外展装置的修复，大多数保肢患者肩关节功能恢复满意。
목적：탐토굉골근단골종류절제후인공가체중건견관절적공능적림상효과。방법대18례굉골근단골종류환자채용종류형굉골근단가체중건견관절，종류류형：골육류6례，연골육류4례，장세포류1례，악성골거세포류4례，전이암3례。골육류、장세포류환자수술전후균접수화료。술후6개월채용MSTS공능평분계통평개술후견관절공능。결과1례실방，17례획수방，시간10～96（52.8±8.4）개월。사망4례，복발1례，견관절반탈위2례。견관절MSTS공능평분위9～27（18．6±3．5）분，기중우8례，량5례，중2례，차2례，우량솔13/17。결론응용종류형굉골근단가체치료굉골상단종류능강저술후병발증，수주의견수화외전장치적수복，대다수보지환자견관절공능회복만의。
Objective To explore the clinical effect of shoulder joint reconstruction with endoprostheses following proximal humerus tumors resection.Methods 18 patients underwent reconstructive procedures of shoulder joint with endoprostheses after intra-articular resection of tumors in the proximal humerus.Histological types were of 6 osteosar-comas,4 osteochondrosarcomas,1 solitary bone plasmacytoma ,4 maligant giant-cell tumors of bone,3 metastatic car-cinomas of bone.The patients with osteosarcomas or bone plasmacytoma received neo-adjuvant chemotherapy.The Musculoskeletal Tomor Society (MSTS)evaluation system was used to assess functional outcome at 6 months postop-eration.Results 17 cases were followed-up for 10~96(52.8 ±8.4)months.1 patient had local recurrence,4 pa-tients died,2 shoulder subluxation.The average MSTS Function score was 9 ~27(18.6 ±3.5)points with 8 excel-lent,5 good,2 fair,2 poor.The rate of the excellent or good was 13/17.Conclusions The method for treatment of tumors in proximal humerus by using endoprostheses can reduce complication after operation.More attention must be played on the reconstruction of the rotator cuff and the abduction mechanisms.Most of patient could reserve the satis-fied function of shoulder joint.