人工肩关节置换.pptVIP

Reconstructions of the shoulder following tumor resection Ways of reconstructions Bone cement Iliac bone Osteoarticular allograft arthrodesis Clavicula pro humeral reconstruction Arthrodesis Free vascularised fibula graft Prosthetic arthroplasty Classification Hemiarthroplasty (humeral head replacements) Total shoulder arthroplasty (TSA glenohumeral replacements) Categories of bone neoplasm Giant cell tumors(GCT) chondroblastoma Chondrosarcoma Osteosarcoma Ewing’s sarcoma Fibrosarcoma Metastatic tumor . . . . . . . . Enneking stages TypeⅠ resection Intra-articular proximal humeral resection TypeⅠA:abductors retained TypeⅠB:abductors resected Comparison Soft tissue reconstruction Soft tissue reconstruction Rehabilitation Complications * * Hemiarthroplasty TSA Unconstrained Hemi-constrained Constrained Ball-cotyla Inverted type III any any yes IIB high out not IIA high in not IB low out not IA low in not stage grade location metastatic malignant tumor 3 aggressive 2 active 1 indolent benign tumor Malawer classification of shoulder girdle resections Magnetic resonance imaging (MRI) Margin of resection A margin of 3 to 4cm distal