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目的 :总结儿童股骨近端病理骨折手术治疗的经验教训。方法 :2 2例 14岁以下的患者接受不同方式的手术治疗 ,平均随访 3 5 .4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。多病灶型骨纤维结构不良经外翻截骨及内固定后可维持正常的颈干角和髋关节功能。肿瘤复发、植骨吸收是常见的并发症。结论 :儿童股骨近端肿瘤合并病理骨折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。
Objective: To summarize the experiences and lessons of surgical treatment of proximal femoral pathological fracture in children. Methods: Twenty-two patients under 14 years of age underwent surgical treatment in different ways with a mean follow-up of 35.4 months. Results: The curettage of the lesion and inactivation of residual tumor tissue in the tumor wall were still the common surgical methods for the treatment of benign lesions. Avoid the epiphysis of the femoral head. Multi-focal type of fibrous dysplasia Orthotomy osteotomy and internal fixation can maintain normal neck angle and hip function. Tumor recurrence, bone graft absorption is a common complication. Conclusion: Surgical treatment of proximal femur neoplasm with pathological fracture should take into account the characteristics of the lesion, the extent of invasion, the stress distribution in the proximal femur, and the absence of epiphysis in children.