Functional Reconstruction of Joint Following Resection of Malignant Bone Tumors around Shoulder Girdle: 28 Cases Report / 中国康复理论与实践

@# ObjectiveTo explore the classification, limb salvage strategy and treatmental results following resection of malignant bone tumors around the shoulder girdle. Methods28 patients with malignant bone tumors of the shoulder girdle underwent a limb-sparing resection according to Malawer's surgical classification system of shoulder girdle. Various limb-salvage procedures were performed for all patients. They were evaluated with survival, recrudesce, and metastasis. The function outcome was assesssed with Enneking Function Evaluation System. Results25 patients were followed-up with a mean time of 54 months (ranged 9～96 months)．6 patients recrudesced, 11 patients died．According to Enneking Function Evaluation System, the mean score of the upper extremity was 23 in reimplantation of tumor-bearing bone after alcohol devitalization group, 24 in osteoarticular allograft group, 24 in free periosteum vascularized clavicle group, 26 point in endoprosthesis group, 25 in the total scapulectomies and the head of humerus slinging group, 28.5 in the partial scapulectomies group respectively. ConclusionThe malignant bone tumors around the shoulder girdle can be resected completely. There were a variety of limb-salvage procedures following tumors resection, with which hand function can be preserved in the majority of patients with relieved pain and good function shoulder.

Venous drainage in the lesser saphenous sural neurovenofasciocutaneous distally based flap:an experimental study in rabbit model / 中华创伤杂志

Objective To investigate the venous drainage of lesser saphenous aural neurov enofasciocutaneous distally based flap through fluorescence tracing technique and discuss the pattern of venous drainage.Methods Venous blood for 0.1 ml was collected from every rabbit ear vein of 20 rabbits respectively for separation of the erythrocytes and labeling with FITC.The lesser saphenous sural neurovenofasciocutaneous distally based flaps were successfully established in hind limbs of 20 rabbits that were then allocated into four groups according to different inspection time points at 30 minutes ( Croup A) ,24 hours (Group B) ,72 hours (Group C) and 7 days (Group D) after operation.The labeled erythrocytes (5 μl) were injected into the flaps via lesser saphenous vein (in Groups A and B)or hypoderma (in Groups C and D).Then,the flaps were removed five seconds (in Groups A and B) or 10 seconds (in Groups C and D) after injection,immediately frozen and sectioned (5-7 μm in thickness) for microscopic analysis of fluorescent distribution in the pedicle.Results FITC-labeled red blood cells showed steady green fluorescence under inversion fluorescence microscope.Fluorescence was mainly distributed in the wall of lesser saphenous vein and peripheral vessels,as well as inner and outer membrane of perforator artery.There was only faint fluorescence around sural nerve in Groups B,C and D.HE staining showed that the lumina of lesser saphenous vein in Groups C and D were fully filled with thrombosis.Conclusions Vein of the lesser saphenous sural neurovenofasciocutaneous distally based flaps is refluxed mainly through wall of lesser saphenous vein and peripheral vessels as well as through inner and outer membrane of perforator artery in the pedicle.Thrombosis occurs in the lumina of lesser saphenous but there is no venous blood reflux through the valve of lesser saphenous vein.

Experimental Study on Stability of Pelvic Ring Reconstruction Using Fibular Autograft for Periacetabular Tumor Type Ⅱ Resection / 中国康复理论与实践

@#Objective To evaluate the stability of the pelvic ring reconstruction using fibular autograft for periacetabular tumor type Ⅱ resection. Methods 6 adult cadaveric specimens were tested. The periacetabular tumor resection models were established according to Ennecking's type Ⅱ resection. The resected pelvic rings were reconstructed with double-fibular graft fixed by four internal fixation techniques including plates, pedicle-rods (PR), lateral-rods (LR) or sacral-iliac rods (SIR). Axial loading from the proximal L3 vertebral body was applied by MTS load cell in the gradient of 0～500 N in the double feet standing state. Images in front view were obtained using CCD camera. Based on Image J software, displacement of the first sacral vertebrae （S1） of the reconstructed pelvis and intact pelvis were calculated using digital maker tracing method with center-of-mass algorithm. Results The rotational movements and vertical displacement of S1 around the normal side femoral head of the reconstructed pelvis in coronary plane were found in simulated bilateral leg standing position. The average vertical load-displacement and load-angular rotation curve of S1 in coronary plane were approximately linear behavior under the vertical load 500 N. The average vertical displacement and angle of S1 in coronary plane had not overacted. The stability of axial direction and rotation had not changed significantly when reconstructed by LR or Plates compared with the intact pelvis, but the SIR did. Conclusion Plates and LR fixation were more stabile for periacetabular tumor type Ⅱ resection.