PDF(Pubmed)
Abstract：
BACKGROUND: The conventional treatment of giant cell tumors is intralesional curettage with local adjuvant therapy. Because hand tumors have a high local recurrence, the primary goal for treating tumors of the hand is to eradicate the lesion.
METHODS: To preserve the metacarpophalangeal (MCP) joint function as well as avoid further recurrence after surgery.
METHODS: The giant cell tumor invades the patient\'s MCP joint in an index proximal phalanx.
METHODS: Using computer-aided design and three-dimensional printing techniques, we reformed the original shapes of the MCP joint and its peripheral bone to replica models. The surgeon then performed an en bloc resection and proximal phalanx with MCP joint reconstruction by fabricating the patient\'s costal osteochondral graft during the operation.
RESULTS: After 6 months of rehabilitation, the patient\'s finger functions could pinch and grasp objects naturally. At the 1-year follow-up, the range of motion of the MCP, proximal interphalangeal, and distal interphalangeal joints improved from flexion of 35° to 60°, 75° to 85°, and 60° to 80°, respectively. The hand function achieved the mean performance of non-preferred hands for young females at the postoperative 3-year follow-up.
CONCLUSIONS: The customized prototyping technique has the potential to replica the original patient\'s bony graft to reach the goal of minimizing the defects at the donor site and maximizing the function of the reconstructed MCP joint.
METHODS: To preserve the metacarpophalangeal (MCP) joint function as well as avoid further recurrence after surgery.
METHODS: The giant cell tumor invades the patient\'s MCP joint in an index proximal phalanx.
METHODS: Using computer-aided design and three-dimensional printing techniques, we reformed the original shapes of the MCP joint and its peripheral bone to replica models. The surgeon then performed an en bloc resection and proximal phalanx with MCP joint reconstruction by fabricating the patient\'s costal osteochondral graft during the operation.
RESULTS: After 6 months of rehabilitation, the patient\'s finger functions could pinch and grasp objects naturally. At the 1-year follow-up, the range of motion of the MCP, proximal interphalangeal, and distal interphalangeal joints improved from flexion of 35° to 60°, 75° to 85°, and 60° to 80°, respectively. The hand function achieved the mean performance of non-preferred hands for young females at the postoperative 3-year follow-up.
CONCLUSIONS: The customized prototyping technique has the potential to replica the original patient\'s bony graft to reach the goal of minimizing the defects at the donor site and maximizing the function of the reconstructed MCP joint.
摘要：
背景：巨细胞瘤的常规治疗是病灶内刮治和局部辅助治疗。因为手部肿瘤有很高的局部复发率，治疗手部肿瘤的主要目标是根除病变。
方法：保护掌指关节（MCP）功能，避免手术后进一步复发。
方法：巨细胞瘤侵犯患者近端指骨的MCP关节。
方法：使用计算机辅助设计和三维打印技术，我们将MCP关节及其外周骨的原始形状改造为复制模型。然后，外科医生通过在手术过程中制作患者的肋骨软骨移植物，进行了整块切除和近端指骨与MCP关节重建。
结果：经过6个月的康复治疗，病人的手指功能可以自然地捏和抓住物体。在1年的随访中，MCP的运动范围,近端指间，远端指间关节从35°屈曲改善到60°，75°到85°,和60°到80°，分别。在术后3年的随访中，手功能达到了年轻女性非首选手的平均性能。
结论：定制的原型技术有可能复制原始患者的骨移植物，以达到最小化供体部位缺陷和最大化重建MCP关节功能的目标。
方法：保护掌指关节（MCP）功能，避免手术后进一步复发。
方法：巨细胞瘤侵犯患者近端指骨的MCP关节。
方法：使用计算机辅助设计和三维打印技术，我们将MCP关节及其外周骨的原始形状改造为复制模型。然后，外科医生通过在手术过程中制作患者的肋骨软骨移植物，进行了整块切除和近端指骨与MCP关节重建。
结果：经过6个月的康复治疗，病人的手指功能可以自然地捏和抓住物体。在1年的随访中，MCP的运动范围,近端指间，远端指间关节从35°屈曲改善到60°，75°到85°,和60°到80°，分别。在术后3年的随访中，手功能达到了年轻女性非首选手的平均性能。
结论：定制的原型技术有可能复制原始患者的骨移植物，以达到最小化供体部位缺陷和最大化重建MCP关节功能的目标。
