四肢长骨病理性骨折的治疗

目的分析石膏托和交锁髓内钉治疗股骨、胫骨、肱骨、桡骨病理性骨折的疗效。方法30例病理骨折(26例骨折、4例临界骨折)采用交锁髓内钉治疗,9例采用石膏托外固定。6例良性病变行病灶刮除、自体和(或)异体骨移植;15例转移癌13例行病灶姑息切除、骨水泥填充加强,2例单纯闭合穿钉固定。结果6例良性病变患者获随访,骨折首次术后平均4.5个月愈合;因复发或内固定失败需再手术2例。15例转移癌获随访,疼痛缓解功能恢复满意。结论交锁髓内钉是治疗股骨、胫骨、肱骨病理性骨折理想的内固定物,外固定可缓解疼痛,但有关节僵硬等并发症。

Treatment for the pathologic fractures in limb long graft bone

Objective To analyze the efficacy of plaster fixation and intra medullary interlocking nail in treating of femoral, humeral and tibial radius pa thologic fractures. Methods 30 cases of pathologic fractures(26 fractures, 4 i mpendine fractures) were treated with intramedullary interlocking nailings. 9cas es were treated with plaster fixation. 6 cases of pathologic fractures due to be nign diseases were undergone lesions resection and autograft and/or allograft. 1 5 cases due to metastatic tumors were undergone palliative lesions resection an d filled with polymethylmethaerylate in 13 cases, merely nailing in 2 cases thro ugh a minimally invasive approach. Results 6 cases of benign diseases got foll ow-up. Fractures got union after 4.5 months on average. 2 patients needed reoper ation due to relapse or failure of implant. 15 cases with metastatic tumor got f ollow-up. All cases got satisfactory recovery of function of affected extremitie s. Conclusion Intramedullary interlocking nailing is an ideal fixation for fem oral, humeral, and tibial pathological fractures. Plaster fixation treatment sho uld be used to those short-term survival cases, not fit to long-term survival ca ses.