Total or subtotal clavicle resection and individualized reconstruction for the treatment of primary malignant clavicle tumors
10.3760/cma.j.cn121113-20220824-00471
- VernacularTitle:全锁骨或次全锁骨切除及个体化重建治疗锁骨原发恶性肿瘤
- Author:
Qinglin JIN
1
;
Wei CHEN
;
Ming LU
;
Changhe HOU
;
Shuangwu DAI
;
Shaohua DU
;
Zixiong LEI
;
Haomiao LI
Author Information
1. 南方医科大学第三附属医院（广东省骨科医院）骨与软组织肿瘤科，骨科临床医学中心，广州 510630
- Keywords:
Clavicle;
Bone neoplasms;
Ligament;
Reconstructive surgical procedures
- From:
Chinese Journal of Orthopaedics
2022;42(20):1340-1347
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the method of repairing huge bone and soft tissue defects in clavicle area after en bloc resection of primary malignant tumor of clavicle and the effect of shoulder joint function.Methods:Data of 3 patients with primary malignant tumors of clavicle who underwent en bloc resection (total or subtotal clavicle resection) and individualized repair of bone and soft tissue defects in clavicular region from January 2018 to December 2021 were retrospectively analyzed. All patients were female aged 45, 57 and 14 years old, respectively. Tumor types were osteosarcoma, solitary plasmacytoma and pleomorphic undifferentiated sarcoma. Postoperative adjuvant chemotherapy, shoulder rehabilitation training were performed. Oncological assessment and shoulder joint activity assessment were regularly performed. Musculoskeletal Tumor Society score (MSTS), Constant-Murley scoring and University of California, Los Angeles (UCLA) scoring system were used for functional assessment of shoulder joint.Results:All 3 cases were followed up with follow-up period of 33, 23 and 8 months respectively. No tumor recurrence or metastasis was detected at the last follow up. After tumor resection, one patient with osteosarcoma and one patient with pleomorphic undifferentiated sarcoma underwent reconstruction with clavicular plate and ligament advanced reinforcement system (LARS) ligament. One patient with solitary plasmacytoma underwent LARS ligament reconstruction only after tumor resection. At the latest follow-up, MSTS scores were 28, 30 and 28, Constant-Murley scores were 80, 90 and 84, and UCLA scores were 29, 33 and 30, respectively. No complications occurred during perioperative and postoperative follow-up period.Conclusion:Reconstruction of clavicle and surrounding important ligaments after en bloc resection of primary clavicle malignant tumor is of great significance to the recovery of postoperative shoulder joint function. Satisfactory stability and good shoulder joint function could be obtained after reconstruction of clavicle and sternoclavicular joint.
