[1]王丰,杨雄刚,刘永恒,等.骨干假体治疗股骨干转移性病理骨折的临床疗效[J].中华老年骨科与康复电子杂志,2017,(04):197-204.[doi:10.3877/cma.j.issn.2096-0263.2017.04.002]
　Wang Feng,YangXionggang,LiuYongheng,et al.Effectiveness of modular intercalary endoprosthesis for femoral metastatic pathological fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(04):197-204.[doi:10.3877/cma.j.issn.2096-0263.2017.04.002]
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骨干假体治疗股骨干转移性病理骨折的临床疗效()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年04期
页码:
197-204
栏目:
髋部骨折
出版日期:
2017-07-15

文章信息/Info

Title:
Effectiveness of modular intercalary endoprosthesis for femoral metastatic pathological fracture
作者:
王丰 1; 杨雄刚 1; 刘永恒 1; 伦登兴 2; 张浩 1; 杨立 1; 赵立明 1; 张慧林 1; 苗军 3; 胡永成 3
300070 天津医科大学 1；261000 山东省潍坊市人民医院骨科 2；300211 天津医院骨肿瘤科 3
Author(s):
Wang Feng1;  YangXionggang1; LiuYongheng1; LunDengxing2; ZhangHao1; YangLi1; ZhaoLiming1; ZhangHuilin1; Miao Jun3;  Hu Yongcheng3
1Tianjin Medical University, Tianjin 300070, China; 2Department of Orthopedics, Weifang People’sHospital,Weifang261000,China;3DepartmentofBoneOncology,TianjinHospital,Tianjin300211,China
关键词:
骨肿瘤;  骨重建;  假体植入
Keywords:
Bone neoplasms;  Bone remodeling;  Prosthesis implantation
DOI:
10.3877/cma.j.issn.2096-0263.2017.04.002
文献标志码:
A
摘要:
目的 探讨股骨干转移瘤病理性骨折切除后骨干缺损进行骨干假体重建的临床疗效。方法 回顾性分析天津医院骨肿瘤科 2011年 7月至 2016年 3月采用骨干瘤段切除假体置换手术治疗的股骨干转移病理性骨折患者 15例，其中男性 6例，女性 9例，年龄 57～81岁，平均年龄（68±9）岁。记录患者的手术时间、术中出血量及截骨长度，对其预期生存时间及实际生存时间进行评估与对比，并依据国际骨与软组织肿瘤协会（MSTS）标准进行评分。结果 手术用时 70（30）min；出血量 800（200）ml；术中平均截骨长度（9.5±2.4）cm，范围：7～16 cm。病理回报：结肠癌转移 1例，肺癌转移 5例，乳腺癌转移 3例，肾癌转移 3例，肝癌转移 2例，未知来源腺癌转移 1例。随访 2～25个月，中位随访时间 7（6）个月，其中 14例患者死亡，1例患者仍存活。死亡患者中位生存时间为 6.5（5）个月。实际生存时间大于预期生存时间且差异有显著统计学意义（Z=-2.935，P＜0.01）。末次随访时，15例患者患肢功能良好，均无局部复发及假体松动，MSTS术后评分平均为（26.0±1.8）分，范围：22～30分。结论 肿瘤瘤段切除骨干假体重建术是治疗股骨干转移病理性骨折的有效术式之一，该术式能够达到安全的外科边界，降低局部复发率，并保留良好的肢体功能。
Abstract:
Objective To explore the clinical effect of group- matched bone prosthesis in the treatment of femoral metastatic pathological fracture and reconstruction of bone defect. Methods Fifteen patients with metastatic carcinoma of femur treated surgically in department of bone oncology, Tianjin Hospital from July 2011 to March 2016 were retrospectively analyzed, including 6 males and 9 females with an average age of 68±9 years (57 to 81). Operation time, intraoperative blood loss and osteotomy length were recorded. The expecting and actual life span was estimated and compared. Results The median operation time was 70(30) min. The median blood loss was 800(200) ml. The mean osteotomy length was 9.5±2.4 cm (7 to 16). The median follow-up was 7(6) months. Fourteen patients deceased and one patient was alive in the last follow up. The median survival was 6.5(5) months for patients deceased. The actual survival time was longer than the expecting survival time by the Dutch model scoring system and difference was significant statistically (Z=-2.935, P<0.05). At the latest follow-up, all patients obtained fine limb function. The mean MSTS score was 26.0 ± 1.8 (22 to 30). No patient had local relapse and prosthesis loosening. Conclusion Modular intercalary endoprosthesis is an effective treatment for segmental defects of femoral metastatic pathological fracture which can achieve safe surgical margins, reduce local recurrence rate and reserve limb function.

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备注/Memo

备注/Memo:
天津市卫生局课题（15KG124）
更新日期/Last Update: 2017-07-14