股骨近端良性肿瘤合并病理性骨折的分期治疗(开放获取)
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天津市天津医院骨与软组织肿瘤病区,天津 300211

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计国旗,主治医师,硕士学位,研究方向:创伤骨科及骨与软组织肿瘤常见病的诊断与治疗,(电话)022-60910242,(电子信箱)951326844@qq.com

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中图分类号:

R683.42

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Staging treatment of proximal femoral benign tumor complicated with pathological fractures
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Department of Bone and Soft Tissue Tumors, Tianjin Hospital, Tianjin 300211 , China

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    摘要:

    [目的] 介绍股骨近端良性肿瘤合并病理性骨折的分期治疗技术及初步临床效果。[方法] 2016 年 1 月—2021 年 9 月对 16 例股骨近端良性肿瘤病理性骨折采用上述方法治疗。入院后评估病情,穿刺明确肿瘤性质,采取卧床、牵引等保守治疗方法,定期复查 X 线片,骨折基本愈合后,行手术治疗。术中对骨壳进行开窗,仔细彻底刮除病灶,搅拌植骨替代物,将其充分填塞至骨缺损中,不留空腔,选择合适的内固定加强局部骨质强度。[结果]16 例均顺利完成手术,术中无神经、血管损伤等并发症发生。随访 8~80 个月,平均 (23.8±18.6) 个月,患者髋关节功能均恢复至正常活动范围,末次随访时 MSTS 下肢评分 27~30 分,平均(28.7±1.0)分。随访过程中均无复发及转移病例。[结论]分期治疗方法,可以保留关节功能,避免关节置换,能够取得良好的临床疗效,是治疗股骨近端肿瘤性病理性骨折的可行性方案。

    Abstract:

    [Objective] To introduce the technique and preliminary clinical consequence of staging treatment of proximal femoral benign tumor complicated with pathological fractures. [Methods] From January 2016 to September 2021, 16 patients received abovementioned treatment for proximal femoral benign tumors with pathological fractures. After admission, the general condition of the patients was assessed, the nature of the tumor was determined by puncture biopsy, and conservative treatment methods such as bed rest and traction were given. As the fractures basically healed according to X-ray taken regularly, the surgical intervention was conducted. During the operation, a fenestration on the bone shell was made to debride the lesion carefully and thoroughly with curettes, and then bone graft substitutes was fully filled into the bone cavity without leaving empty space, finally, appropriate internal fixation was placed to strengthen the local bone strength. [Results] All the 16 patients successfully completed the operation, without complications such as nerve and vascular injury. The patients were followed up for 8 to 80 months with a mean of (23.8±18.6) months. At the last follow-up, all the patients regained normal range of motions of the hip with MSTS lower extremity score of (28.7±1.0), ranged from 27 to 30. No recurrence or metastasis happened in anyone of them during the followup. [Conclusion] This staging treatment does preserve joint function, avoid joint replacement, and achieve good clinical outcome, which is a feasible therapy for neoplastic pathological fractures of the proximal femur.

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计国旗,刘艳成,张净宇,等. 股骨近端良性肿瘤合并病理性骨折的分期治疗(开放获取)[J]. 中国矫形外科杂志, 2025, 33 (11): 1033-1038. DOI:10.20184/j. cnki. Issn1005-8478.110257.
JI Guo-qi, LIU Yan- cheng, ZHANG Jing-yu, et al. Staging treatment of proximal femoral benign tumor complicated with pathological fractures[J]. Orthopedic Journal of China , 2025, 33 (11): 1033-1038. DOI:10.20184/j. cnki. Issn1005-8478.110257.

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  • 收稿日期:2024-04-01
  • 最后修改日期:2024-11-16
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  • 在线发布日期: 2025-06-09
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