POEMS综合征伴病理性骨折一例

狄鹤轩; 齐典文; 赵茗; 张国川

doi:10.3969/j.issn.2095-252X.2024.09.013

摘要：Objective To describe the surgical treatment of a case of POEMS syndrome with a pathologic fracture of the femur and review of the relevant literature.Methods The surgical resection and application of 3D printed prosthesis reconstruction to treat a case of POEMS syndrome combined with pathologic fracture were described.The diagnosis of POEMS syndrome with pathologic fracture was made through a series of tests and laboratory tests,such as blood routine,electromyography,pulmonary function test,and surgical pathology.A 3D-printed prosthesis with preserved knee joint was designed for the patient before surgery.The pain visual analogue scale was used to assess the surgical outcome,and the MSTS 93 scale was used to assess the clinical efficacy at the final follow-up.Results Surgery completely resected the right femoral lesion and reconstructed limb function.The patient's VAS score decreased from 8 preoperatively to 3 postoperatively.One year postoperatively,the patient's surgical incision was well healed and the prosthesis was in position with no deformity of the hip.At the final follow-up,the patient's MSTS 93 score was 22.An individualized rehabilitation plan was developed for the patient in order to achieve better functional recovery.Conclusions Surgical resection and reconstruction are effective for patients with POEMS syndrome with pathologic fractures.3D-printed customized prosthesis is a promising reconstruction technique for patients with long segmental lesions.Although there is no standardized treatment for POEMS syndrome with pathologic fracture,the prognosis and quality of life can be improved through active comprehensive treatment.