PDF(Pubmed)
Abstract：
Bone tumors of the upper limb are a common cause of bone pain and pathological fractures in both old and young populations. Surgical reconstruction and limb salvage have become valid options for these patients despite this kind of surgery being challenging due to the need for wide bone resection and the involvement of surrounding soft tissues. Computer-assisted technology helps the surgeon in pre-operative planning and in designing customized implants. The aim of this study was to investigate the surgical outcomes and complications of custom-made prostheses in oncologic reconstruction of the upper limb and if they are reliable options for patients suffering from aggressive tumors. An electronic search on PubMed, Google Scholar, and Web of Knowledge was conducted to identify all available articles on the use of custom-made prostheses in oncological resections of the upper limb. Twenty-one studies were included in the review, comprising a total of 145 patients with a mean age of 33.68 years. The bone involved was the humerus in 93 patients, and the radius was involved in 36 patients. There were only six cases involving proximal ulna, three cases involving the scapula, and seven cases involving the elbow as well as soft tissues around it. The most frequent primary tumor was the giant cell tumor, with 36 cases, followed by osteosarcoma with 25 cases, Ewing Sarcoma with 17 cases, and Chondrosarcoma with 7 total cases. Forty patients were affected by bone metastases (such as renal cell cancer, breast cancer, melanoma, and rectal cancer) or hematologic diseases involving bone (lymphoma, myeloma, or non-Hodgkin disease). Custom-made prostheses are a viable option for patients who suffer from malignant tumors in their upper limbs. They are a reliable aid for surgeons in cases of extensive resections.
摘要：
上肢骨肿瘤是老年人和年轻人群中骨痛和病理性骨折的常见原因。尽管由于需要广泛的骨切除和周围软组织的参与，这种手术具有挑战性，但手术重建和肢体抢救已成为这些患者的有效选择。计算机辅助技术可帮助外科医生进行术前计划和设计定制植入物。这项研究的目的是调查上肢肿瘤重建中定制假体的手术结果和并发症，以及它们是否是患有侵袭性肿瘤的患者的可靠选择。在PubMed上进行电子搜索，谷歌学者，并进行了WebofKnowledge，以确定所有有关在上肢肿瘤切除术中使用定制假体的可用文章。21项研究被纳入审查，共145名患者，平均年龄33.68岁。93例患者的肱骨受累,36例患者累及桡骨。只有6例涉及尺骨近端,三例涉及肩胛骨，七例涉及肘部及其周围软组织。最常见的原发性肿瘤是巨细胞瘤，36例，其次是骨肉瘤25例，尤因肉瘤17例,软骨肉瘤共7例。40例患者受骨转移（如肾细胞癌，乳腺癌,黑色素瘤，和直肠癌）或涉及骨骼的血液系统疾病（淋巴瘤，骨髓瘤,或非霍奇金病）。定制的假体对于患有上肢恶性肿瘤的患者是可行的选择。在广泛切除的情况下，它们是外科医生的可靠帮助。
