UNASSIGNED: The clinical data of 32 patients with DTF in the shoulder girdle admitted between June 2003 and December 2016 were retrospectively analyzed, including 14 males and 18 females, aged 14-56 years with an average age of 36.8 years. The maximum diameter of the tumor was 7-19 cm, with an average of 11.1 cm. According to the \"West China Classification\" of DTF in the shoulder girdle, there were 4 cases of region Ⅰ, 3 cases of region Ⅱ, 6 cases of region Ⅲ, 3 cases of region Ⅳ, 5 cases of regions Ⅰ+Ⅱ, 5 cases of regions Ⅱ+Ⅲ, and 6 cases of regions Ⅰ+Ⅱ+Ⅲ. In addition, the involvement of blood vessels and nerves was also taken into consideration for choosing a surgical approach. Finally, 12 cases were operated via anteroposterior approach (group A), 14 via posterior approach (group B), and 6 via combined anterior-posterior approach (group C). The 1993 Musculoskeletal Tumor Society (MSTS93) score (including pain, limb function, satisfaction, hand position, hand flexibility, and lifting ability), Japanese Orthopedic Association (JOA) score, range of motion (ROM) of shoulder joint (including flexion, extension, abduction, and adduction), and complications of patients in the 3 groups were recorded and compared.
UNASSIGNED: All the 32 patients were followed up 30-190 months, with an average of 94.6 months. At last follow-up, complications occurred in 5 cases (15.6%), including 2 cases (16.6%) in group A, 2 (14.3%) in group B, and 1 (16.6%) in group C. There was no significant difference in the incidence of complications among the 3 groups ( P=1.000). Tumor recurrence occurred in 5 (15.6%) cases, including 1 (8.3%) case in group A, 2 (14.3%) in group B, and 1 (16.6%) in group C. No significant difference was found in the recurrence rate among the 3 groups ( P=1.000). At last follow-up, MSTS93 score of pain, limb function, satisfaction, hand flexibility, and hand position in groups A and B were significantly better than those in group C ( P<0.05), even though no significant difference existed between group A and group B ( P>0.05). The lifting ability score in group C was significantly lower than in group A ( P<0.05), and no significant difference was found between other groups ( P>0.05). The JOA score and flexion, extension, abduction, and adduction activities of shoulder in groups A and B were significantly better than those in group C ( P<0.05). The extension activity in group A was significantly better than that in group B ( P<0.05), the flexion activity in group B was significantly better than that in group A ( P<0.05). There was no significant difference in other indexes between groups A and B ( P>0.05).
UNASSIGNED: Taking a rational approach to fully expose and completely remove the tumor is the key point of surgical treatment for patients with DTF in the shoulder girdle. At the same time, preservation of vital structures and reconstruction of soft tissues should also be taken into consideration. Overall, surgical treatment under the guidance of \"West China Classification\" of DTF in the shoulder girdle has achieved satisfactory long-term effectiveness.
UNASSIGNED: 评估肩胛带韧带样纤维瘤(desmoid-type fibromatosis,DTF)华西分区指导外科治疗的远期临床疗效。.
UNASSIGNED: 回顾分析 2003 年 6 月—2016 年 12 月收治的 32 例肩胛带 DTF 患者临床资料,男 14 例,女 18 例;年龄 14~56 岁,平均 36.8 岁。肿瘤最大径 7~19 cm,平均 11.1 cm。根据肩胛带 DTF 华西分区,肿瘤位于 Ⅰ 区 4 例、Ⅱ 区 3 例、Ⅲ 区 6 例、Ⅳ 区 3 例、Ⅰ+Ⅱ 区 5 例、Ⅱ+Ⅲ 区 5 例、Ⅰ+Ⅱ+Ⅲ 区 6 例。根据肩胛带 DTF 华西分区及血管神经受累情况,12 例采用前路手术(A 组),14 例采取后路手术(B 组),6 例采用前-后联合入路手术(C 组)。记录并比较 3 组患者 1993 美国骨肿瘤学会评分系统(MSTS93) 评分(包括疼痛、肢体功能、满意度、手的位置、手灵活度、举物能力 6 方面)、日本骨科协会(JOA)评分、肩关节活动度(包括前屈、后伸、外展、内收)及并发症发生情况。.
UNASSIGNED: 32 例患者均获随访,随访时间 30~190 个月,平均 94.6 个月。随访期间共 5 例(15.6%)患者发生并发症,其中 A 组 2 例(16.6% )、B 组 2 例(14.3%)、C 组 1 例(16.6%),各组并发症发生率比较差异均无统计学意义( P=1.000)。至末次随访时,共 4 例(12.5%)患者肿瘤复发,其中 A 组 1 例(8.3%)、B 组 2 例(14.3%)、C 组 1 例(16.6%),各组复发率比较差异均无统计学意义( P=1.000)。末次随访时,A、B 组 MSTS93 评分的疼痛、肢体功能、满意度、手灵活性、手的位置评分及总分均显著优于 C 组( P<0.05),A、B 组间差异无统计学意义( P>0.05);C 组举物能力评分显著低于 A 组( P<0.05),其余组间比较差异无统计学意义( P>0.05)。A、B 组 JOA 评分及肩关节前屈、后伸、外展、内收活动度均显著优于 C 组( P<0.05);A 组后伸活动度优于 B 组,B 组前屈活动度优于 A 组,差异有统计学意义( P<0.05),其余指标 A、B 组间差异均无统计学意义( P>0.05)。.
UNASSIGNED: 根据肩胛带 DTF 华西分区选择适当的手术入路,充分暴露并完整切除肿瘤,取得了较满意的远期临床疗效。.