旋转成形术治疗15例股骨恶性肿瘤及其功能评定

[目的] 探讨旋转成形术治疗股骨上下端恶性肿瘤的远期疗效与患肢功能。[方法] 回顾分析股骨恶性肿瘤15例，术式按Winkelmann分型：AⅠ型13例，BⅠ型2例，结合手术前后化疗6例，放疗2例。患肢功能按国际保肢学会（ISOLS)评估标准。[结果] 存活最短时间12个月，最长12年。5年内因肺转移死亡7例，局部复发l例．5年生存率53.3％。另l例肺转移于7年死亡。7年局部复发l例，7年生存率46．6％，复发率13.3％(2／15)。所有存活病人患肢足部感觉与运动功能良好，优良率87．5％。[结论] 旋转成形术治疗股骨下端恶性肿瘤远期疗效较满意，局部复发率较低，且能最大限度保留患肢功能。

Rotationplasty in The Treatment for 15 Cases with Malignant Femur Tumor and The Function Assessment

To evaluate the long-term results and function assessment of rotationplasty in the treatment for malignant femur tumor.Fifteen patients with rotationp lasty for the treatment of femur tumor were evalu-ated clinically and functiona lly.Winkelmann-type AI rotationplasty was performed in thirteen cases,BI in tw o cases.Six patients received pre-and postoperative chemotherapy.Radiotherapy was used for two patients.The limb function was evaluated with score of the ISO LS.The patients were followed for an average of seventy-seven months(r anged,12to148months).The patients'survival period ranged from12months to12years .Seven patients died of lung metastasis within five years and another died withi n seven years.Two patients were found have the local recur-rence.The five and s even years survival rate were53.3%and46.6%respectively while the7year local rec urrent rate was13.3%(2/15).All alive patients achieved satisfied walking functio n and sense of foot with the rotationplas-ty.The excellent rate according to I SOLS's functional evaluation was87.5%.[Conclusions]Rotationplasty can get a sat isfied long-term results for the treatment of malignant femur tumor.It can pres erve maximum limb function with less local recurrence.