The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Surgical treatment for the clavicular malignant tumors

Author : ZHU Tian-ping, MA Huan-zhi, ZHANG Wei, et al.     
Working unit : 1 Department of Orthopedics, Lingcheng Traditional Chinese Medical Hospital, Dezhou 253500, China; 2 Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
Page : 220-225
Key words : clavicle, malignancy, claviculectomy,reconstruction, allograft

Abstract:

Objective

To explore clinical characteristics of clavicular malignant tumor and evaluated the postoperative oncologic and functional results.

Methods

From January 2006 to June 2015, 16 patients with clavicular malignancy underwent total or partial claviculectomy, including that 6 patients got clavicular reconstruction with allograft (the reconstruction group), the remaining 10 patients had claviculectomy alone (the non-reconstruction group) . Of them, 10 males and 6 females aged on average of 53 years ranged from 6 to75 years. Furthermore, 7 patients had the tumor on the left side while 9 on the right side, in? cluding 5 of metastatic tumor, 4 of plasmacytoma, 1of myeloma, 3 of Ewing??s sarcoma, 1 of fibrosarcoma, 1 of non-Hodgkin lymphoma and 1 of chondrosarcoma. In term of tumor resection, 8 patients had the tumor widely excised, 7 patients had marginally excised, whereas the remainig 1 patient got only the intra-lesion resection. Musculoskeletal Tumor Society score and Constant-Murley score were used for evaluation.

Results

The patients were followed up for an average of 30 months ranged from 12 to 60 months. Only 2 patients with metastatic lesion, including 1 from lung cancer and 1 from kidney cancer, suffered from local recurrence, while the remaining 14 patients had no local recurrence. Of the 16 patients, 6 died of the malignancy, whereas the remaining 10 patients were alive without recurrence. As result of non-union of allograft reconstruction with or without fixation loosening in 2 of the 6 patients, the allograft and fixation were finally removed. The MSTS Scores and Constant-Murley scores in the reconstruction group were not significantly higher than those in the non-reconstruction group (P=0.159 and P=0.462) .

Conclusion

Claviculectomy can provide good local tumor control. Patients with allograft reconstruction had no better function than those without reconstruction. Considering the non-union of bone, allograft reconstruction is not recommended.


summary:
Surgical treatment for the clavicular malignant tumors   
ZHU Tian-ping, MA Huan-zhi, ZHANG Wei, et al.
Orthop J Chin,2018,26(3):   220-225