■比较微波辅助病灶内刮治(MAIC)与整块切除和自体腓骨重建(EBR-AFR)治疗III级骨巨细胞瘤的临床结果。桡骨远端(GCTB),并阐明腕关节保留手术的适应症。
■在这项回顾性研究中,纳入了在三家医疗机构接受手术的19例桡骨远端GCTBIII级患者,并根据其手术方式进行了分类。7例患者接受了MAIC和骨水泥内固定(MAIC组),12例接受了EBR-AFR(EBR-AFR组)。术后评估患肢的功能,手腕的运动范围,握力,记录肌肉骨骼肿瘤协会(MSTS)评分。
■MAIC组随访时间为73.57±28.61(36-116)个月,无复发或肺转移。相比之下,EBR-AFR组随访时间为55.67±28.74(36~132)个月,局部复发1例(8.3%,1/12)和1例肺转移(8.3%,1/12)。手腕弯曲,扩展,仰卧起坐,内旋,MAIC组的握力优于EBR-AFR组.虽然两组的MSTS评分无统计学差异,值得注意的是,与EBR-AFR组相比,MAIC组表现出明显的情感接受度和手部定位(p<0.05)。
■MAIC组的功能结果更好。桡骨远端III级GCTB的治疗策略应根据具体的术前影像学检查结果确定。然而,MAIC可以作为多数桡骨远端Ⅲ级GCTB患者的首选手术入路,特别是年轻患者。
UNASSIGNED: To compare the clinical outcomes of microwave-assisted intralesional curettage(MAIC) with those of en bloc resection and autogenous fibular reconstruction (EBR-AFR) for treating grade III giant cell tumor of the bone (GCTB) of the distal radius and to elucidate the indications for wrist preservation surgery.
UNASSIGNED: In this retrospective study, 19 patients with grade III GCTB of the distal radius who underwent surgery at three medical institutions were included and categorized based on their surgical pattern. Seven patients underwent MAIC and internal fixation with bone cement (MAIC group) and 12 underwent EBR-AFR (EBR-AFR group). To evaluate the function of the affected limb postoperatively, wrist range of motion, grip strength, Musculoskeletal Tumor Society (MSTS) scores were recorded.
UNASSIGNED: The follow-up time of the MAIC group was 73.57 ± 28.61 (36-116) months, with no recurrence or lung metastasis. In contrast, the follow-up time of the EBR-AFR group was 55.67 ± 28.74 (36-132) months, with 1 case of local recurrence (8.3%, 1/12) and 1 case of lung metastasis (8.3%, 1/12). The wrist flexion, extension, supination, pronation, grip strength were better in the MAIC group than in the EBR-AFR group. Although there was no statistically significant difference in the MSTS score between the two groups, it is noteworthy that the MAIC group exhibited significantly superior emotional acceptance and hand positioning compared to the EBR-AFR group(p < 0.05).
UNASSIGNED: The functional outcomes of the MAIC group are better. The treatment strategy for grade III GCTB of the distal radius should be determined based on the specific preoperative imaging findings. Nevertheless, MAIC can be the preferred surgical approach for most patients with grade III GCTB of the distal radius, particularly for young patients.