【摘要】：目的·分析橈骨遠(yuǎn)端Campanacci 3級(jí)骨巨細(xì)胞瘤患者的預(yù)后及其與術(shù)后腕關(guān)節(jié)穩(wěn)定性相關(guān)影像學(xué)參數(shù)的關(guān)系。方法·收集2003年8月—2016年7月接受腫瘤廣泛切除聯(lián)合同側(cè)自體腓骨重建術(shù)的15例橈骨遠(yuǎn)端Campanacci 3級(jí)骨巨細(xì)胞瘤患者資料,對(duì)臨床及影像學(xué)資料進(jìn)行回顧,分析患者預(yù)后及其與腕關(guān)節(jié)穩(wěn)定性相關(guān)影像學(xué)參數(shù)的關(guān)系。結(jié)果·15例患者中14例完成隨訪,1例失訪;平均隨訪時(shí)間為(62.3±43.3)個(gè)月�；颊咝g(shù)前和術(shù)后國(guó)際骨與軟組織腫瘤協(xié)會(huì)(MSTS)評(píng)分分別為21.6±2.0和23.1±2.2,功能有所改善,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.106)。與術(shù)前比較,術(shù)后疼痛評(píng)分(MSTS)和生活功能評(píng)分(MSTS)改善顯著(4.1±0.5vs 2.9±0.7,P=0.000;3.7±0.7 vs 3.0±0.7,P=0.012)。相比對(duì)側(cè),術(shù)后患側(cè)腕關(guān)節(jié)的關(guān)節(jié)活動(dòng)度為(63.4±12.6)%,握力為(68.5±10.8)%。5例出現(xiàn)并發(fā)癥(占35.7%),其中感染1例,骨不連3例,半脫位1例;無(wú)下肢功能障礙病例。術(shù)后MSTS評(píng)分為"良"和"優(yōu)"患者的側(cè)位片腓尺夾角分別為8.8?±5.6?和2.2?±2.4?(P=0.018);克氏針取出前后尺腓關(guān)節(jié)間隙的差異有統(tǒng)計(jì)學(xué)意義(P=0.003)。Pearson相關(guān)性分析結(jié)果顯示骨愈合時(shí)間與取出克氏針后的腓骨尺偏角呈正相關(guān)(r=0.60,P=0.022)。結(jié)論·對(duì)于橈骨遠(yuǎn)端骨巨細(xì)胞瘤廣泛切除聯(lián)合同側(cè)自體腓骨重建術(shù)患者,其預(yù)后可能與術(shù)后腕關(guān)節(jié)穩(wěn)定性相關(guān)影像學(xué)參數(shù)有關(guān)。這對(duì)腓骨重建有一定的指導(dǎo)意義。
[Abstract]:Objective to analyze the prognosis of patients with Campanacci grade 3 giant cell tumor of radius and its relationship with postoperative wrist stability. Methods from August 2003 to July 2016, 15 patients with Campanacci grade 3 giant cell tumor of distal radius underwent extensive tumor resection combined with ipsilateral autologous fibula reconstruction, and the clinical and imaging data were reviewed. The prognosis of the patients and the relationship between the prognosis and the imaging parameters related to the stability of wrist joint were analyzed. Results of the 15 patients, 14 completed the follow-up and 1 lost the follow-up, and the average follow-up time was (62.3 鹵43.3) months. The (MSTS) scores of the International Association of Bone and soft tissue Oncology before and after operation were 21.6 鹵2.0 and 23.1 鹵2.2, respectively. the function of the patients was improved, but the difference was not statistically significant (P 鈮，

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