PURPOSE OF THE STUDY: Pelvic reconstructions after massive bone resections are among the most challenging practices in orthopedic surgery. Whether the bone gap results after a trauma, a tumor resection, or it is due to a prosthetic revision, it is mandatory to reconstruct pelvic bone continuity and rebuild the functional thread that connects spine and hip joint. Several different approaches have been described in literature through the decades to achieve those goals. MATERIAL AND METHODS: To this date, 3D-printed implants represent one of the most promising surgical technologies in orthopedic oncology and complex reconstructive surgery. We present our experience with 3D-printed custom-made pelvic prostheses to fulfi ll bone gaps resulting from massive bone loss due to tumor resections. We retrospectively evaluated 17 cases treated with pelvic bone reconstruction using 3D-printed prostheses. Cases were evaluated in terms of both oncological and functional outcomes. RESULTS: At the last follow-up, local complications were found in 6 cases (36%): in 4 (23.5%) of them the cause was a local recurrence of the disease, whereas only 2 (12.5%) had non-oncologic issues. The mean MSTS score in our population increased from 8.2 before surgery to 22.3 at the latest clinical control after surgery. DISCUSSION: 3D-printing technology, used to produce cutting jigs and prosthetic implants, can lead to good clinical and functional outcomes. These encouraging results are comparable with the ones obtained with other more frequently used reconstructive approaches and support custom-made implants as a promising reconstructive approach. CONCLUSIONS: Our data confi rm 3D-printing and custom-made implants as promising technologies that could shape the next future of orthopedic oncology and reconstructive surgery. KEY WORDS: custom made prosthesis, pelvic reconstruction, orthopedic oncology, cutting jigs, 3D-printing.
- MeSH
- 3D tisk MeSH
- artrodéza MeSH
- lidé MeSH
- nádory * MeSH
- pánevní kosti * chirurgie MeSH
- retrospektivní studie MeSH
- technologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY: Hand enchondromas are benign cartilage bone tumors. Curettage represents the actual gold standard for hand enchondromas. Little has been written about the effectiveness of curettage on hand functionality. MATERIAL AND METHODS: In this retrospective study, we evaluated the effectiveness of curettage and bone grafting on the hand. For each case, we compared the pre-operative and post-operative QuickDASH of the treated limb. The final functional outcome was also evaluated by calculating the affected finger's Total Active Movement (TAM). Complications and local recurrences were recorded. RESULTS: Forty-five cases were included in our study. Fifteen of them had a pathological fracture. The mean pre-operative QuickDASH score was 48.4. No intraoperative complications occurred. After a mean follow-up of 38.1 months, the mean QuickDASH score had decreased to 4.4, and the TAM was optimal or sub-optimal. QuickDASH and TAM were significantly better for those with pathologic fractures before surgery. Only 3 cases (7%) had postoperative complications, and 1 (2%) had a local recurrence. DISCUSSION: Our results prove the effectiveness of curettage and early rehabilitation in increasing and restoring the performances of the treated hands. Our patients experienced a significant improvement in their functionality after surgery, generally passing from a poor to an excellent status. In our cohort, those who had a pathologic fracture before surgery had slightly but significantly worse functional outcomes compared to those who did not suffer pre-operative lesions. CONCLUSIONS: Curettage and early postoperative rehabilitation can lead to good clinical and functional outcomes for hand enchondromas. Patients with pathologic fractures, although slightly exposed to a higher risk of sub-optimal outcomes, can also aim for good post-operative functionality. KEY WORDS: hand, chondroma, QuickDASH, fracture, rehabilitation.
- MeSH
- chondrom * chirurgie MeSH
- kyretáž * metody MeSH
- lidé MeSH
- nádory kostí * chirurgie MeSH
- retrospektivní studie MeSH
- transplantace kostí metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
