儿童股骨近端骨肿瘤的手术治疗Surgical Treatment for Proximal Femoral Tumors in Children
詹新立,周江南,李康华,邓展生,龙文荣,廖前德,张朝跃
摘要(Abstract):
目的:总结儿童股骨近端骨肿瘤手术治疗的经验教训。方法:37例14岁以下的患者接受不同方式的手术治疗,平均随访37.2个月。结果:病变刮除、瘤壁残留肿瘤组织灭活、植骨术仍是目前治疗良性病变常用的手术方法,应避免损伤股骨头骨骺。对病灶范围较大伴有髋内翻畸形的良性病变,行病变部分刮除、外翻截骨及内固定后可维持正常的颈干角和髋关节功能。瘤段切除、长柄人工股骨头置换术,是修复股骨近端恶性骨肿瘤切除后大块骨缺损的一种较好的方法,具有早期恢复肢体功能、并发症少、材料来源充足等优势。结论:儿童股骨近端骨肿瘤的手术治疗应考虑到病变的性质、侵袭范围、股骨近端的应力分布及儿童骨骺未闭合等特点,采用适当的术式,多可获得良好的效果。
关键词(KeyWords): 骨肿瘤;儿童;股骨近端;手术
基金项目(Foundation):
作者(Author): 詹新立,周江南,李康华,邓展生,龙文荣,廖前德,张朝跃
Email:
DOI:
参考文献(References):
- (1) 侯希敏,陈德喜,唐胜建,等.同种异体胎儿骨临床应用 ??的研究(附40例报告)[J].中华骨科杂志,1990,10(6) :441.
- (2) Enneking WF, Dunham W, Gebhardt MC, et al. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system[J]. Clin Orthop, 1993, 286: 241~246.
- (3) 马保安,范清宇.恶性骨肿瘤的误诊误治分析[J].中华骨科杂志,1996,16:309.
- (4) Hiroyuki T, Katsuro T, Yoshihiko M, et al. Marginal excision for osteosarcoma with caffine assisted chemotherapy [J]. Clin Orthop, 1999, 358: 27~35.
- (5) Mellower MM, Bickels J, Meller Ⅰ, et al. Cryosurgery in the treatment of giant cell tumor. A long-term followup study[J]. Clin Orthop, 1999, 359: 176~188.
- (6) 李军,范靖宇,马保安,等.四肢单灶性纤维结构不良[J].中国矫形外科杂志,2000,8:748~750.
- (7) Guille JT, Kumar SJ, MacEwen GD. Fibrous dysplasia of the proximal part of the femur. Long-term results of curettage and bone-grafting and mechanical realignment [J]. J Bone Joint Surg Am, 1998, 80(5) : 648~658.