锁定钢板固定联合骨水泥填充治疗四肢长骨转移癌伴病理性骨折的疗效观察

目的 探讨锁定钢板固定联合骨水泥填充治疗四肢骨干转移癌伴病理性骨折的疗效.方法 收集2006年1月至2011年12月宁夏医科大学总医院应用锁定钢板固定联合骨水泥填充治疗四肢长骨转移癌伴病理性骨折21例,男性13例,女性8例,年龄40 ～ 75岁,平均53.6岁,术前术后分别应用视觉模拟评分法（VAS）进行疼痛缓解评定、Enneking评分法进行肢体功能评价、Kanofsky法进行生活质量评价.结果 全部病例获得随访,随访5 ～36个月,平均27.3个月.所有患者均安全度过围手术期,术后无感染及其他并发症.术后VAS评分较术前明显降低（t=22.04,P＜0.05）.Enneking评分结果显示21例中优7例,良8例,中2例,差1例,优良率达71.4％.术后Kanofsky评分较术前明显提高（t=-7.384,P＜0.05）.结论 锁定钢板固定联合骨水泥填充治疗四肢骨干转移癌伴病理性骨折疗效显著,是四肢骨转移癌伴病理性骨折手术治疗的一种选择.

The Efficiency of the Internal Fixation with Locked Plate and Bone Cement to Long Bone Pathologic Fractures due to Metastatic Carcinoma

Objective To explore the efficiency of the internal fixation with locked plate and bone cement to long bone pathologic fractures due to metastatic carcinoma.Methods From January 2006 to December 2011,21 cases suffering from long bone pathologic fractures due to metastatic carcinoma treated with internal fixation with locked plate and bone cement were collected in the general hospital of Ningxia medical university.The cases included 13 males and 8 females with an average of 53.6 years old.Visual analog scale （VAS） was used to assess for pain relief and Enneking score was used to assess for evaluation of limb function while Kanofsky evaluation method was used to assess the quality of life in preoperative and postoperative cases.Results All patients were followed up after operation for ranging from 54-36 months,with an average of 27.3 months.All patients were safe perioperative and there were no infection and other complications.The Postoperative VAS score was significantly lower than Preoperative that （t =22.04,P ＜ 0.05）.15 postoperative patients （71.4％） got excellent and good Enneking scores.The Postoperative Kanofsky score was significantly higher than Preoperative that（t =-7.384,P ＜0.05）.Conclusion The internal fixation with locked plate and bone cement to long bone pathologic fractures due to metastatic carcinoma has a nice effect,and it provides a good choice of surgical treatment.