涉及桡骨远端骨巨细胞瘤的外科手术疗效比较.

Objective: To compare the clinical effect and safety of patients with giant cell tumor in distal radius treated with different operations. Methods: 88 patients with giant cell tumor in distal radius who had surgical indications were involved. 3 major operations were used in the treatment according to the Campanacci grading system. Group A were treated with hyperthermia by inserted microwave antennas after tumor exposure in situ and the resulted bone defect were reconstructed with the compound including self-ilium,allogeneic bone powders and bone cement. Patients in group B underwent en bloc resection of bone tumor with autologous fibula.Patients in group C underwent curettage, adjuvant phenol therapy, and bone grafting. Clinical outcomes were evaluated by Enneking, and the cost, recurrence was compared between three groups. Results: The tumor recurred in 5 patients in group A with a recurrence rate of10.87 %. According to the Enneking functional evaluation system, MSTS93 score was 26.32 ±2.92. None people in B group had the recurrence and the MSTS93 score was 22.85±4.16. The recurrence rate of group C was 33.33 % and MSTS93 score was 22.97±3.84.There were significant statistical differences in recurrence rate between 3 groups(P<0.05). The functional score in A and C are significantly better than that in B group, while there was no significant statistical difference between A and C(P>0.05). There was 1superficial infection in A group and 2 cases in B group, which were cured dressing. Conclusions: En bloc resection of bone tumor could reduce the recurrence rate while it had the poor function recovery and more risks of complications. Microwave-induced hyperthermia could kill the tumors completely and had better function recovery, but it had the great recurrence. The schedule of surgery should be done according to patients’ condition. [ABSTRACT FROM AUTHOR]