1. Outcome of segmental prosthesis reconstruction for diaphyseal bone tumors: a multi-center retrospective study
- Author
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Xiu-chun Yu, Kai Zheng, Baichuan Wang, Ming Xu, Zengwu Shao, Yong‐cheng Hu, and Feng Wang
- Subjects
Male ,0301 basic medicine ,Cancer Research ,medicine.medical_treatment ,Prosthesis ,law.invention ,Intramedullary rod ,0302 clinical medicine ,law ,Bone reconstruction ,Aged, 80 and over ,Prostheses and Implants ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Primary tumor ,Prosthesis Failure ,Retrospective study ,Treatment Outcome ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Segmental prostheses ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Bone Neoplasms ,Diaphyseal defects ,lcsh:RC254-282 ,Prosthesis Implantation ,Young Adult ,03 medical and health sciences ,Genetics ,medicine ,Humans ,Femur ,Humerus ,Tibia ,Aged ,Retrospective Studies ,business.industry ,Ulna ,Plastic Surgery Procedures ,medicine.disease ,Surgery ,Diaphysis ,Diaphysis tumors ,030104 developmental biology ,Assistant plate ,Pathological fractures ,Diaphyses ,business - Abstract
Background The optimal reconstructive method after diaphyseal malignant bone tumor resection remains controversial. This multicenter clinical study was designed to investigate the clinical value and complications of segmental prosthesis in the repair of diaphyseal defects. Methods We present 49 patients from three clinical centers treated with wide resection for primary or metastatic bone tumors involving the diaphysis of the femur, tibia, humerus, or ulna, followed by reconstruction using a modular intramedullary segmental prosthesis. Results Enrolled patients included 23 men and 26 women with a mean age of 63.3 years. Of these, seven patients had primary bone tumors and 42 patients had metastatic lesions. At the mean follow-up of 13.7 months, 17 patients were alive, 31 patients were deceased due to tumor progression, and one patient was dead of another reason. There were eight nononcologic complications (two with radial nerve injury, three with delayed incision healing, two with aseptic loosening in the proximal humerus prosthetic stem and one with structural failure) and three oncologic complications (three with primary tumor recurrence) among all patients. The incidence of complications in primary tumor patients (4/7, 57.1%) was higher than that in patients with metastatic tumors (7/42, 16.7%) (p = 0.036). Aseptic loosening and mechanical complications were not common for patients with primary tumors, although the reconstruction length difference was statistically significant (p = 0.023). No statistically significant differences were observed in limb function, while the mean musculoskeletal tumor society score was 21.2 in femora, 19.6 in humeri, and 17.8 in tibiae (p = 0.134). Conclusions Segmental prostheses represent an optional method for the reconstruction of diaphyseal defects in patients with limited life expectancy. Segmental prostheses in the humerus experienced more complications than those used to treat lesions in the femur.
- Published
- 2019