Xiang-Dong Li

Publications (2)0 Total impact

• Article: Functional outcomes and complications of reconstruction of the proximal humerus after intra-articular tumor resection.

  Zhen Wang, Zheng Guo, Jing Li, Xiang-dong Li, Hong-xun Sang
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  ABSTRACT: To evaluate functional outcomes and complications of reconstruction of the proximal humerus after intra-articular tumor resection. Twenty-five patients who underwent Malawer I type resection and reconstruction of the proximal humerus for treatment of malignant or invasive benign tumors from August 1999 to August 2005 were evaluated. A variety of reconstructive procedures, including modular tumor prosthesis, osteoarticular allograft, and allograft-prosthetic composite (APC), were performed after resection of tumor. Oncological and radiographic parameters were evaluated. The modified Musculoskeletal Tumor Society (MSTS) evaluation system was used to assess limb functional outcome. The study group consisted of 10 male and 15 female patients, among which there were 20 malignant and 5 benign tumors. Restoration of shoulder function was achieved with a prosthesis in 6 patients, osteoarticular allograft in 12, and allograft-prosthesis composite in 7. At a mean of 48 months follow-up, 2 patients had died of disease. Two patients had local recurrence and 2 had metastatic disease. On the basis of the modified MSTS functional evaluation, the mean scores were 22.50 in the modular prosthesis group, 24.58 in the osteoarticular allograft group, and 27.00 in APC group, respectively. Joint instability and subluxation were serious complications affecting shoulder function in 10 patients. Reconstruction of the proximal humerus is an option that provides good relief of pain and preserves manual dexterity. Functional outcomes are better for APC and allograft than for modular prosthesis, due to retention of the rotation cuff. Complications in the APC group were less than in the allograft one.
  Orthopaedic Surgery 02/2010; 2(1):19-26.
• Article: [Reconstruction with a new type of combined reconstruction following excision of periacetabular tumors].

  Zheng Guo, Zhen Wang, Jing Li, Xiang-dong Li
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  ABSTRACT: To evaluate the reconstructive effect of a new pattern of combined reconstruction after periacetabular tumor resections. Between March 2001 and March 2007, tumor resections and new pattern of combined reconstructions which consisted of screw-rod system, acetabular reinforcement shell, antibiotic cement and total hip arthroplasty techniques were performed in 23 patients with periacetabular tumors. There were 7 females and 16 males. The mean age was 43 years (range, 16-78 years). Seventeen patients had primary malignant tumors including 7 chondrosarcomas, 4 osteosarcomas, 2 Ewing sarcomas, 2 malignant fibrohistiocytomas, 1 malignant Schwannomas, and 1 synovial sarcoma. Other primary tumors were 2 giant cell tumors and 1 aggressive osteoblastoma. Three metastatic bone tumors were also included in this study, and the original sites were thyroid, breast, and ovary. According to Enneking's staging system, there were 1 case in IA, 5 cases in IB, 3 cases in IIA, and 8 cases in IIB. Three primary benign bone tumors belonged to stage III. The average follow-up was 36. 8 months (range, 9-73 months) in the patients with primary tumors. The survival time in 3 patients with metastatic disease were between 9.6 months and 36. 6 months. There were 4 patients who had local recurrence, 5 patients had pulmonary metastases, and 5 patients died of disease. No wound complication was encountered. The postoperative complications included 3 cases of screw loosening, 2 cases of prosthetic dislocation, 3 cases of leg length discrepancy, 2 cases of deep vein thrombosis, 1 case of partial neuropraxia of sciatic nerve. The complication rate related to implants was 21.7%. The average MSTS functional score was 68% for all patients at 6 months postoperatively, and 62% for 6 patients with follow-up time more than 5 years. This new combined reconstruction is an effective way to rebuild pelvic ring and maintain hip function with low complication rate after periacetabular tumor resections.
  Zhonghua wai ke za zhi [Chinese journal of surgery] 07/2008; 46(12):895-9.