摘要
目的本研究旨在探讨骨肿瘤患者接受全部或部分锁骨切除后,上肢功能状况及肩关节活动度状况。方法本研究共纳入9例锁骨肿瘤在我院接受全部或部分锁骨切除术。回顾分析患者的肿瘤学结果及肩关节功能。功能评分采用MSTS评分,ASES评分及UCLA评分系统及肩关节活动度。比较患者双侧肩关节功能及活动度的差异,分析原因及对患者的影响。结果平均随访时间17.6(6~44)个月,1例软骨肉瘤患者术后14个月出现局部软组织复发,接受第二次手术。二次术后16个月再次出现复发,行第三次切除手术。术后14个月,患者肺转移,局部无复发。1例骨肉瘤,术后3个月出现肺转移,局部无复发。其它7例随访时均未出现复发或转移。9例患侧上肢平均MSTS评分(94.6±2.1)%(80%~100%),健侧上肢为100%,差异有统计学意义。患侧肩关节平均ASES评分为(96.9±1.2)%(92.8%~100%),健侧为(99.2±0.8)%(92.8%~100%),两侧差异无统计学意义。患侧的UCLA评分为(33.1±0.8)(29~35),健侧为(34.8±0.2)(33~35),两侧差异有统计学意义。患者的肩关节活动度基本满意,患侧与健侧各方向活动度差异无统计学意义。结论锁骨切除术可作为锁骨肿瘤患者的一种有效术式,切除后患侧肩关节功能及活动度较对侧稍差,但MSTS评分,ASES评分及UCLA评分均达优良功能,可满足患者的日常功能需求。
Objective To evaluate upper extremity and shoulder joint functions after total or partial claviculectomy. Methods Nine clavicle tumor patients were included. MSTS, ASES, UCLA scoring systems, clinical range of motion of the shoulder were compared. Related factors and effects on patients were analyzed. Results The mean follow-up was 17.6 months（ range： 6-44 months）. One patient with chondrosarcoma showed local recurrence 14 months after the first surgery and accepted the second operation, but recurrence was found 16 months later and the third surgery was conducted. Fourteen months later, lung metastasis was found in this patient without local recurrence. Lung metastasis was found in 1 patient with osteosarcoma 3 months after operation, and no local recurrence was found. No recurrence or metastasis occurred during the follow-up in the remaining 7 patients. The mean MSTS score of the operation side was（ 94.6 ± 2.1） %（ range： 80%-100%）, and 100% for the non-operation side with statistical significance（ P〈0.05）. The mean ASES score of the operation side was（ 96.9 ± 1.2） %（ range： 92.8%-100%）, and（ 99.2 ± 0.8） %（ range： 92.8%-100%） for the non-operation side with statistical significance（ P〈0.05）. The range of motion of the shoulder was satisfactory, and there were no significant differences between the aclaviculate side and the control side. Conclusions Claviculectomy serves as an effective method for clavicle tumor. Although the function and range of motion are not so good, normal daily life can be ensured. MSTS, ASES, UCLA results are satisfactory.
作者
金韬
刘巍峰
徐海荣
牛晓辉
JIN Tao, LIU Wei- feng, XU Hai-rong, NIU Xiao-hui(Department of Orthopedic Oncology Surgery, Beijing Jishuitan Hospital, Beijing, 100035, China)
出处
《中国骨与关节杂志》
CAS
2018年第9期646-649,共4页
Chinese Journal of Bone and Joint
关键词
骨肿瘤
锁骨
外科手术
肩关节
Bone neoplasms
Clavicle
Surgical procedures
operative
Shoulder joint
