Abstract:
Background: Intraosseous hemangiomas occurring the clavicle is uncommon. Reconstruction of the clavicle is suggested to maintain the normal shoulder joint function and prevent adverse outcomes. Complex anatomy shape of the clavicle remains a great challenge for prosthetic reconstruction of the clavicle. Case presentation: A 37-year-old female with no conclusive history of trauma presented with progressive mass at the right lateral clavicle for 5 years. The patient was treated by surgical resection and reconstructed by three-dimensional-printed personalized prosthesis. Postoperatively radiographic examinations revealed a good position of the prosthesis, neither breakage nor loosening was detected. The right shoulder mobility returned to approximate level of preoperative shoulder 2 months after surgical reconstruction, with the range of motion of flexion 80°, extension 40°, abduction 80°, adduction 30°, external rotation 55°, and internal rotation 60°. The patient maintained the normal shoulder function during the 48 months follow-up period. There was no pain during shoulder motion. The Musculoskeletal Tumor Society Score (MSTS) score was 29 and the Functional Evaluation Form recommended by the American Shoulder and Elbow Surgeons (ASES) score was 95. Conclusion: 3D-printed personalized prosthesis is a good option to reconstruct the lateral clavicle bone defect and restore the shoulder support structure. It maintains the normal shoulder joint function and avoids adverse effects on daily activities after claviculectomy.
摘要:
背景:锁骨内血管瘤并不常见。建议重建锁骨以维持正常的肩关节功能并防止不良后果。锁骨的复杂解剖形状仍然是锁骨假体重建的巨大挑战。病例介绍:一名37岁的女性,没有明确的外伤史,在右锁骨外侧出现进行性肿块5年。患者通过手术切除治疗,并通过三维打印的个性化假体进行重建。术后影像学检查显示假体位置良好,未检测到断裂或松动。术后2个月右肩活动度恢复到术前肩关节的水平,弯曲80°的运动范围,延伸40°,外展80°,内收30°,外旋55°,和内部旋转60°。患者在48个月的随访期间维持了正常的肩关节功能。在肩部运动期间没有疼痛。肌肉骨骼肿瘤协会评分(MSTS)为29分,美国肩肘外科医生推荐的功能评估表(ASES)评分为95分。结论:3D打印个性化假体是重建锁骨外侧骨缺损、恢复肩关节支撑结构的良好选择。维持肩关节正常功能,避免锁骨切除术后对日常活动的不良影响。