Factors that influence functional outcome after total or subtotal scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) study.
Factors that influence functional outcome after total or subtotal scapulectomy: Japanese Musculoskeletal Oncology Group (JMOG) study.
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DOI：
10.1371/journal.pone.0100119
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Tsuchiya H
中科院分区：
文献类型：
--
作者：
Hayashi K;Iwata S;Ogose A;Kawai A;Ueda T;Otsuka T;Tsuchiya H
肩胛骨切除术不仅需要关节切除，还需要广泛切除肩胛带肌肉。由于难以比较不同的条件，甚至重建的意义也尚未确定。本研究的目的是在一项多中心研究中调查影响肩胛骨切除术后功能结局的因素。这项回顾性研究包括48例接受全肩胛骨或次全肩胛骨切除术的患者，并在术后随访至少一年。患者在日本肌肉骨骼肿瘤组附属医院登记。当有足够的剩余组织用于肩袖和肌腱重建时，进行软组织重建以稳定关节。23例行肱骨外上悬术。平均随访时间为61.9个月。使用患者的背景进行多变量分析，以确定哪些因素影响Enneking功能评分或活动范围。平均功能评分为21.1分（满分30分）。主动肩关节活动度屈曲42.7 °，外展39.7 °，内旋49.6 °，外旋16.8 °。剩余骨量影响功能结果，这意味着保留肩盂或肩峰与全肩胛切除术相比，可获得更好的功能（p<0.01）。影响各项功能指标的因素有剩余骨量、软组织重建、肱骨切除长度和神经切除（p<0.05）。虽然全肩胛骨切除术或次全肩胛骨切除术后肩关节功能几乎消失，但最小限度的骨切除和软组织重建应能改善功能。
Scapulectomy requires not only joint resection but also wide resection of the shoulder girdle muscles. Even the significance of reconstruction has not yet been determined because of the difficulties in comparing the different conditions. The purpose of this study was to investigate factors that influence functional outcomes after scapulectomy in a multicenter study. This retrospective study comprised 48 patients who underwent total or subtotal scapulectomy and were followed for at least one year after surgery. Patients were registered at the Japanese Musculoskeletal Oncology Group affiliated hospitals. Soft tissue reconstruction for joint stabilization was performed when there was enough remaining tissue for reconstruction of the rotator cuff and tendons. In 23 cases, humeral suspension was performed. The average follow-up period was 61.9 months. Multivariate analysis was performed using the patient’s background to determine which factors influence the Enneking functional score or active range of motion. The average functional score was 21.1 out of 30. Active shoulder range of motion was 42.7 degree in flexion, 39.7 degree in abduction, 49.6 degree of internal rotation and 16.8 degree of external rotation. The amount of remaining bone influenced functional outcome, which means that preserving the glenoid or the acromion lead to better function compared to total scapulectomy (p<0.01). Factors that influenced each functional measure include the amount of remaining bone, soft tissue reconstruction, the length of the resected humerus and nerve resection (p<0.05). Although shoulder function was almost eliminated following total or subtotal scapulectomy, minimal resection of bone, and soft tissue reconstruction should lead to better function.
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影响因子：
1.7
作者：
Tanzawa, Yoshikazu;Tsuchiya, Hiroyuki;Tomita, Katsuro
通讯作者：
Tomita, Katsuro
影响因子：
2.5
作者：
Mavrogenis, Andreas F.;Mastorakos, Dimitrios P.;Papagelopoulos, Panayiotis J.
通讯作者：
Papagelopoulos, Panayiotis J.
影响因子：
3
作者：
Tang, Xiaodong;Guo, Wei;Sun, Xin
通讯作者：
Sun, Xin
DOI：
10.1186/1756-9966-28-45
发表时间：
2009-04-01
影响因子：
11.3
作者：
Zhang, Kaiwei;Duan, Hong;Tu, Chongqi
通讯作者：
Tu, Chongqi
DOI：
10.1097/01.blo.0000030510.43495.e6
发表时间：
2002-12-01
影响因子：
4.2
作者：
Mnaymneh, WA;Temple, HT;Malinin, TI
通讯作者：
Malinin, TI