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19例股骨颈原发溶骨性损害的手术治疗
Hits: 1989   Download times: 1190   Received:October 19, 2000    
作者Author单位UnitE-Mail
齐新生 QI Xin-sheng 东南大学附属中大医院,江苏南京210009 Zhongda Hospital affiliated to Southeast University,Jiangsu Nanjing,210009  
姚维清 YAO Wei-qing 铜陵市第二人民医院  
陈辉 CHEN Hui 东南大学附属中大医院,江苏南京210009 Zhongda Hospital affiliated to Southeast University,Jiangsu Nanjing,210009  
樊克文 东南大学附属中大医院,江苏南京210009 Zhongda Hospital affiliated to Southeast University,Jiangsu Nanjing,210009  
期刊信息:《中国骨伤》2001年14卷,第12期,第711-713页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:总结股骨颈原发溶骨性损害的手术治疗结果。

方法:自1973~1999年共收治股骨颈原发溶骨性病损19例,其中瘤样病变11例,良性肿瘤4例,恶性骨肿瘤2例,骨梗死2例。采用瘤段切除、人工股骨头置换1例,肿瘤刮除、骨水泥和髓内钉填塞、接骨板固定2例,肿瘤刮除植骨16例。

结果:随访6个月~20年,平均58年。骨肉瘤患者术后2年死于肿瘤肺转移,软骨肉瘤患者术后15年肿瘤局部复发,行股骨近端置换。1例骨水泥和三翼钉填入者8年后患侧股骨粗隆部骨折,再次手术安装接骨板,3个月后骨折愈合,余患者4~8个月植骨融合,无股骨头坏死或塌陷,肿瘤无复发征象。

结论:原发股骨颈溶骨性损害以瘤样病变居多。良性病变无论病变范围的大小,采用病灶清除、腔内植骨或骨水泥填塞均取得良好效果。
[关键词]:骨肿瘤  股骨颈  骨折固定术,髓内
 
Treatment of primary osteolytic lesions of femoral neck,a report of 19 cases
Abstract:

Objective:To evaluate the operative effect of primary osteolytic lesions of femoral neck

Methods: 19 cases of primary and osteolytic lesions of femoral neck were treated from 1973 to 1999.There were 11 cases of tumor-like lesion,4 of benign bone tumor,2 of malignant and 2 of bone infarct.1 was treated by segmental resection and prosthetic femoral head replacement,2 by curettage, followed by bone cement and medullary nail plugging and 16 by curettage and bone grafts.

Results:The mean period of follow-up was 5 8 years(from 0 5 to 20 years).19 cases with bone sarcoma died of the pulmonary metastasis at 2 years after operation,the condrosarcoma recurred locally at 1 5 years and a secondary replacement of proximal femur was done.1 of bone cement and medullary nail plugging complicated with unilateral intertrochanteric fracture after 8 years and then fixed with plate resulted with bony union in 3 months.The other patients had bony fusion from 4 to 8 months and there were no recurrence or femoral head necrosis.

Conclusion: Most of the primary and osteolytic lesions of femoral neck were tumorlike lesions.The curettage and bone grafts or bone cement filling was an effective method for the benign lesions.
KEYWORDS:Bone neoplasms Femur neck Fracture fixation  intramedullary
 
引用本文,请按以下格式著录参考文献:
中文格式:齐新生,姚维清,陈辉,樊克文.19例股骨颈原发溶骨性损害的手术治疗[J].中国骨伤,2001,14(12):711~713
英文格式:QI Xin-sheng,YAO Wei-qing,CHEN Hui.Treatment of primary osteolytic lesions of femoral neck,a report of 19 cases[J].zhongguo gu shang / China J Orthop Trauma ,2001,14(12):711~713
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