PMC9868392_01
Photograph of the patient showing the right lateral clavicle mass.
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F1
Physical examination indicated a hard mass located lateral clavicle area approximately 8 x 4 x 4 cm in size, with no overlying erythema (Figure 1).
Preoperative image data of the patient. (A) Anteroposterior X-ray of the right clavicle showing an large and expansive lesion (Red Arrow), with another lesion involving coracoid process (Blue Arrow). (B, C) Computed tomography (CT) images showing osteolytic lesions with cortex-destructing. Magnetic resonance imaging showing the expansive lump with isointensity to muscle on a (D) T1-weighted image and homogeneous hyperintensity on a T2-weighted image (E). (F) 3D model of the shoulder reconstructed from CT scans.
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F2
The X-ray and computed tomography (CT) scan revealed an expansive and osteolytic lesion with cortex-destructing in the right lateral clavicle (Figure 2).
(A) Reconstructed virtual 3D tumors and clavicle models. (B) The virtual 3D personalized prosthesis model. (C) Simulated implantation of the prosthesis with a curved intramedullary stem.
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F3
Lastly, "Region Grow" was used to segment out the bone (Figure 3).
Profile of the prosthesis.
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F4
The preliminary prosthesis shape was designed by mirroring the contralateral normal clavicle model (Figure 4).
Intraoperative pictures. (A) Resection of the lateral clavicle was performed. (B) Implantation of the prosthesis. (C) Photograph of the resected tumor specimens.
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F5
The clavicle tumor resection was performed precisely according to the preoperative plan (Figure 5).
(A, B) 12-month and 36-month postoperative anteroposterior view X-ray. (C) The anteroposterior digital tomosynthesis graph showed no radiolucent lines around the intramedullary stem.
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F6
Postoperatively radiographic examinations revealed a good position of the prosthesis, neither breakage nor loosening was detected (Figure 6).