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目的总结1例肩胛骨并骨盆骨转移瘤同期手术的方法及效果。方法2007年6月收治1例63岁男性滤泡状甲状腺癌右侧肩胛骨并左侧骨盆骨转移瘤。右肩胛部有一8cm×5cm肿块,质韧,边界清晰,不活动;右肩功能部分受限,外展70°,外旋45°,外展上举120°;左髋活动轻度受限。同期行右侧全肩胛骨切除和左侧骨盆切除并特殊定制的半骨盆假体重建术。结果术后切口Ⅰ期愈合。患者获随访2年,恢复日常生活。右肩功能部分受限,外展50°,外旋20°,外展上举90°;患髋无明显疼痛不适,行走时步态正常。关节功能根据国际保肢协会标准评分,右肩关节18分,左髋关节24分。随访期间肿瘤无复发。结论全肩胛骨切除和半骨盆切除并重建术是治疗肩胛骨及骨盆骨转移瘤的一种有效方法。
Objective To summarize the methods and effects of simultaneous surgery of scapular and pelvic bone metastases. Methods One case of 63-year-old male with follicular thyroid carcinoma in the right scapula and left pelvic bone metastases was treated in June 2007. The right scapular has a 8cm × 5cm mass, quality and toughness, the boundary is clear and inactive; right shoulder function is limited, abduction 70 °, external rotation 45 °, abduction on the move 120 °; left hip mildly limited activity. In the same period, the right shoulder scapula and the left pelvic resection and special custom semi pelvic prosthesis reconstruction. Results Postoperative incision healed. Patients were followed up for 2 years to restore daily life. Right shoulder function is partially limited, abduction 50 °, external rotation 20 °, abduction on the move 90 °; no obvious pain and discomfort in the hip, walking gait is normal. Joint function according to the International Association of limb salvage rating, right shoulder 18 points, left hip 24 points. No recurrence of tumor during follow-up. Conclusion All scapular and pelvic excision and reconstruction is an effective method for the treatment of scapular and pelvic bone metastases.