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目的探讨股骨近段肿瘤外科治疗方式的选择。方法股骨近段肿瘤患者57例,依据肿瘤类型及骨损害程度选择刮除、切除、植骨、骨水泥填充、动力髋螺钉(DHS)、锁定钢板(LCP)、股骨近段髓内钉(PFN)、定制型肿瘤假体置换术(CHR)及髋关节离断术行外科治疗;采用Enneking评分进行术后关节功能评估。结果 57例中,病灶刮除+植骨和/或内固定术21例,病灶刮除+骨水泥填充+内固定术21例,瘤段切除+CHR术11例,髋关节离断术2例,单纯病变切除2例。随访3-60个月(中位时间31.2个月),Enneking关节功能评分:1例髋部畸形矫形术后异位骨化者<21分;2例患者接受了髋关节离断术;其余患者术后6个月均达26分以上。结论股骨近段骨肿瘤根据肿瘤类型及损害程度选择合适的术式,治疗效果及功能恢复均良好。
Objective To explore the surgical treatment of proximal femur. Methods Fifty-seven patients with proximal femoral neoplasm were selected according to the type of tumor and the degree of bone damage. DHS, LCP, PFN ), Custom-made tumor prosthesis replacement (CHR) and hip ablation surgery. The Enneking score was used to evaluate the postoperative joint function. Results Among the 57 cases, 21 cases were treated with curettage, bone graft and / or internal fixation, 21 cases with curettage, bone cement filling and internal fixation, 11 cases with tumor resection and CHR, 2 cases with hip ablation , Simple lesions in 2 cases. All the patients were followed up for 3-60 months (median, 31.2 months). The Enneking joint function score was 1 in 21 patients with heterotopic ossification of hip deformity and 2 in 2 patients undergoing hip ablation. The remaining patients 6 months after surgery reached 26 points or more. Conclusion Adjacent femoral bone tumors according to the type of tumor and the degree of damage to choose the appropriate surgical procedure, the treatment effect and functional recovery are good.