Kaan ERLER, Bahtiyar DEMİRALP, M. Taner ÖZDEMİR, Mustafa BAŞBOZKURT

Total femur rezeksiyonu ve prostetik replasmanın başarılı sonuçları: İki olgu sunumu

Femurun tümünün rezeke edilmesi ve oluşan defektin endoprostetik replasmam, önemli bir ekstremite kurtarıcı prosedürdür. Evre UB osteosarkom tanısıyla, 20 yaşında-ki iki erkek hastada total femur rezeksiyonu ve TMTS (Turkish Musculoskeletal Tumor Society) protezi ile replasman uygulandı. Ameliyat sonrası dönemde geçici siyatik sinir nöropraksisi ve hafif yara komplikasyomı dışında bir sorunla karşılaşılmadı. Dört aşamalı rehabilitasyon programı uygulanan hastalar desteksiz ve sınırlama olmadan yürüyebiliyorlardı. İzlem süreleri 22 ve 26 ay olan hastalarda kalça ve dizde tama yakın hareket genişliğine ulaşıldı ve Enneking fonksiyonel skorları mükemmel bulundu. Endoprostetik total femoral rekonstrüksiyon, dikkatli seçilmiş hastalarda, rekonstrüktif prosedürlere bağlı kalınarak uygulandığında tatminkar fonksiyonel sonuçlar sağlamaktadır.

Anahtar Kelimeler:

Rekonstrüktif cerrahi işlemler, Osteosarkom, Kemik neoplazmları, Protezler ve implantlar, Femur, Protez tasarımı, Protez implantasyonu

Successful results of total femoral resection and prosthetic replacement in two patients

Resection of the whole femur, together with endoprosthet-ic replacement is a major limbsalvaging procedure. We performed total femoral resection and endoprosthetic replacement with TMTS (Turkish Musculoskeletal Tumor Society) prosthesis in two young (20 years old) male patients with stage-IIB osteosarcoma. Postoperative com-plications were only temporary sciatic nerve neuropraxia and minor skin necrosis around the surgical wound. After a four staged individualized rehabilitation program, both patients were able to walk without any support or limita-tion. At the end of a follow-up period of 22 and 26 months, both patients achieved a nearly full range of motion of the knee and the hip, with Enneking functional scores being excellent. Endoprosthetic total femoral reconstruction results in satisfactory oncologic and functional outcome in selected patients.

Keywords:

Reconstructive Surgical Procedures, Osteosarcoma, Bone Neoplasms, Prostheses and Implants, Femur, Prosthesis Design, Prosthesis Implantation,

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