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The long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma.

骨肉瘤切除术后儿童可伸展肱骨内假体的长期结果。

  • 影响因子:3.58
  • DOI:10.1302/0301-620X.102B12.BJJ-2020-0124.R1
  • 作者列表:"Tsuda Y","Fujiwara T","Stevenson JD","Parry MC","Tillman R","Abudu A
  • 发表时间:2020-01-01
Abstract

AIMS:The purpose of this study was to report the long-term results of extendable endoprostheses of the humerus in children after the resection of a bone sarcoma. METHODS:A total of 35 consecutive patients treated with extendable endoprosthetic replacement of the humerus in children were included. There were 17 boys and 18 girls in the series with a median age at the time of initial surgery of nine years (interquartile range (IQR) 7 to 11). RESULTS:The median follow-up time was 10.6 years (IQR 3.9 to 20.4). The overall implant survival at ten years was 75%. Complications occurred in 13 patients (37%). Subluxation at the proximal humerus occurred in 19 patients (54%) but only six (17%) were symptomatic. Subluxation was seen more commonly in children under the age of nine years (86%) than in those aged nine years or more (33%) (p = 0.002). Implant failure occurred in nine patients (26%): the most common cause was aseptic loosening (four patients, 11%). Lengthening of the implant was carried out in 23 patients (66%). At final follow up, three patients had a limb that was shortened by 5 cm or more. The mean Musculoskeletal Tumor Society (MSTS) functional score was 79% (73% to 90%). CONCLUSION:Extendable endoprosthetic replacement is a reliable method of reconstructing humerus after excision of a bone sarcoma. Children who are less than nine years old have a high risk of subluxation. Cite this article: Bone Joint J 2020;102-B(1):64-71.

摘要

目的: 本研究的目的是报告儿童可伸展肱骨内假体切除骨肉瘤后的长期结果。 方法: 共纳入 35 例接受可伸式肱骨内假体置换术治疗的儿童患者。该系列中有 17 名男孩和 18 名女孩,初次手术时的中位年龄为 9 岁 (四分位距 (IQR) 7 ~ 11 岁)。 结果: 中位随访时间为 10.6 年 (IQR 3.9 ~ 20.4)。十年时总体种植体生存率为 75%。13 例 (37%) 发生并发症。19 例 (54%) 患者发生肱骨近端半脱位,但只有 6 例 (17%) 有症状。半脱位常见于 9 岁以下儿童 (86%),多于 9 岁以上儿童 (33%) (p = 0.002)。种植体失败 9 例 (26%): 最常见的原因是无菌性松动 (4 例,11%)。23 例患者 (66%) 进行了植入物延长。在最后的随访中,3 例患者的肢体缩短了 5厘米或更多。平均肌肉骨骼肿瘤协会 (MSTS) 功能评分为 79% (73% ~ 90%)。 结论: 伸展式假体置换是一种可靠的治疗方法。小于 9 岁的儿童发生半脱位的风险较高。引用本文: 骨关节J 2020;102-B(1):64-71。

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DOI:10.1259/bjr.20180883
作者列表:["Tran S","Puric E","Walser M","Poel R","Datta NR","Heuberger J","Pica A","Marder D","Lomax N","Bolsi A","Morach P","Bachtiary B","Seddon BM","Schneider R","Bodis S","Weber DC"]

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影响因子:1.41
发表时间:2020-03-01
DOI:10.1177/1078155219842277
作者列表:["Gyori DJ","Bullington SM","Crawford BS","Vernon VP"]

METHODS:BACKGROUND:National guidelines recommend screening and treatment for cancer-related bone disease and continued monitoring of bone-modifying agents. It is unclear whether a standardized screening tool is utilized to identify eligible patients and ensure appropriate supportive care is implemented. The purpose of this study was to evaluate current prescribing practices and optimize management of bone-modifying agents. METHODS:A retrospective chart review was performed to identify patients who received hormone deprivation therapy or had bone metastases through Hematology/Oncology or Urology clinics from 1 November 2016 to 31 October 2017. The primary endpoints of this study were the incidence of completed baseline dual-energy X-ray absorptiometry (DEXA) scan for patients on hormone deprivation therapy and percent of patients started on a bone-modifying agent for the prevention of skeletal-related events secondary to bone metastasis. Secondary endpoints included percent of patients with dental examinations prior to initiation, adequate calcium and vitamin D supplementation, incidence of osteonecrosis of the jaw or flu-like symptoms and education, and percent of bisphosphonate doses appropriately adjusted based on renal function. RESULTS:A total of 375 patients were assessed for baseline DEXA scans and bone-modifying therapy. Of the 226 patients on hormone deprivation therapy, 111 (49%) patients were appropriately screened with a DEXA scan prior to initiation of hormone deprivation therapy. Among the 149 patients with bone metastases, only 94 (63.1%) patients were started on a bone-modifying agent. CONCLUSIONS:Opportunities have been identified to optimize management of patients with cancer-related bone disease. Implementation of standardized tools may increase the rate of appropriate screening and initiation of bone-modifying therapy when warranted.

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影响因子:2.83
发表时间:2020-01-01
DOI:10.1007/s00520-019-04843-9
作者列表:["Dohzono S","Sasaoka R","Takamatsu K","Hoshino M","Nakamura H"]

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骨肿瘤方向

骨肿瘤是发生于骨骼或其附属组织的肿瘤。有良性,恶性之分,良性骨肿瘤易根治,预后良好,恶性骨肿瘤发展迅速,预后不佳,死亡率高。

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