HOW I DO IT Total Scapulectomy and Constrained Reverse Total Shoulder Reconstruction for a Ewing's Sarcoma
HOW I DO IT Total Scapulectomy and Constrained Reverse Total Shoulder Reconstruction for a Ewing's Sarcoma
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DOI：
10.1002/jso.21340
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发表时间：
2009-12-01
影响因子：
2.5
通讯作者：
Papagelopoulos, Panayiotis J.
中科院分区：
文献类型：
--
作者：
Mavrogenis, Andreas F.;Mastorakos, Dimitrios P.;Papagelopoulos, Panayiotis J.
背景资料：全肩胛骨切除术和关节内切除的盂肱关节表示Malawer III型肩带references.Materials和方法：改良的Tikhoff-Linberg全肩胛骨切除术和限制性反向全肩重建的尤文氏肉瘤的肩胛骨。采用了综合办法。保留三角肌、阔肌、菱形肌、肩胛提肌、背阔肌和前锯肌。通过肩锁关节和盂肱关节的离断，将肿瘤整体切除。肩胛骨假体由肌肉悬吊。结果：术中、术后均无并发症，手术切缘清晰，无严重并发症。在12个月后，病人有一个稳定和无痛shoulder.Conclusion：肩关节重建的目标是提供一个稳定和无痛的关节，允许定位的手臂和手的空间。与那些没有肩胛骨重建的患者相比，肩胛骨和肩部的假体置换部分恢复了外展和外旋，并改善了美观。外科肿瘤学杂志2009;100：611-615. (C)2009 Wiley-Liss，Inc.
Background: Total scapulectomy and intra-articular resection of the glenohumeral joint indicates the Malawer Type III shoulder girdle resection.Materials and Methods: The modified Tikhoff-Linberg total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing's sarcoma of the scapula is presented. A combined approach has been used. The deltoid, trapezius, rhomboids, levator scapulae, latissimus dorsi, and serratus anterior were preserved. the tumor was removed en bloc by disarticulation of the acromioclavicular and the glenohumeral joints. The scapular prosthesis was suspended by the muscles. A constrained reverse humeral prosthesis was implanted after osteotomy of the humeral head.Results: There were no intraoperative or postoperative complications; surgical margin, were clear. At 12 months postoperatively, the patient has a stable and painless shoulder.Conclusion: The goal of shoulder reconstructions is to provide a stable and painless joint that allows positioning of the arm and hand in space. Compared to those patients left without a scapula reconstruction, prosthetic replacement of the scapula and shoulder partially restores abduction and external rotation and improves cosmesis. J. Surg. Oncol. 2009;100:611-615. (C) 2009 Wiley-Liss, Inc.