人工间置型假体置换治疗长骨骨干恶性肿瘤（附4例报告）

目的探讨人工间置型假体置换治疗长骨骨干恶性肿瘤的手术方法与疗效。方法 2008年6月-2010年6月,4例长骨骨干恶性肿瘤患者于我院接受骨干瘤段切除人工间置型假体置换手术。4例均为男性,年龄24～60岁,平均41岁。其中股骨干恶性纤维组织细胞瘤1例,肺癌单发股骨干转移瘤1例,软组织腺泡状肉瘤胫骨干转移瘤1例,肾癌单发肱骨干转移瘤1例。结果获得随访16～40个月。截止末次随访时,4例患者患肢功能良好,MSTS评分平均为28.3分（27～30分）。均无局部复发。其中3例无瘤生存;1例胫骨干转移瘤患者术前已有肺转移,术后9个月出现脑转移,目前带瘤存活。结论肿瘤瘤段截除人工间置型假体置换术是治疗长骨骨干恶性肿瘤的有效术式之一,该术式能够达到安全的外科边界,降低局部复发率,并保留良好的肢体功能。

Intercalary spacers reconstruction for long bone diaphyseal malignant tumors: a report of 4 cases

Objective To discuss the methods and therapeutic effects of intercalary spacers reconstruction for the treatment of diaphyseal defects following the resection of long bone tumors. Methods Four patients with malignant long bone tumors （including 1 femur malignant fibrous histiocytoma, 1 femur solitary metastatic tumor secondary to lung cancer, 1 tibia metastatic tumor secondary to alveolar soft part sarcoma and 1 humerus solitary metastatic tumor secondary to renal cancer） were treated surgically from June 2008 to June 2010. They were all males, and the average age was 41 （24 to 60） years old. Results The mean follow-up was 27 months （16 to 40 months）. In the latest follow-up, all patients obtained limb function. The mean MSTS score was 28.25 （27 to 30）. No patient had local relapse. Three cases survived without tumor, 1 case survived with the metastatic tumor of bibia which had pulmonary metastasis before surgery and brain metastasis 9 months after surgery. Conclusion Intercalary spacers reconstruction is an effective treatment of diaphyseal long bone tumors which can achieve safe surgical margins, reduce local recurrence rate and reserve limb fimction.