人工节段型骨干假体重建治疗肱骨骨干肿瘤

目的探讨人工节段型骨干假体重建治疗肱骨骨干肿瘤的可行性、手术方法以及疗效评估。方法回顾性分析2008年4月至2012年6月期间我院采用肿瘤广泛切除和节段型骨干假体重建术治疗6例肱骨骨干肿瘤患者的手术方案及疗效。6例患者中男性2例，女性4例，年龄为19~74岁，平均50．8岁；其中肱骨干单纯性骨囊肿2例、肺癌单发肱骨干转移瘤2例、肱骨干动脉瘤样骨囊肿1例及肱骨干富含巨细胞纤维性病变1例。结果术后随访8～58个月，平均29．5个月。截至末次随访，5例患者存活，1例患者于术后2（）个月死亡。存活患者肿瘤无局部复发、假体松动等并发症，末次随访时患肢功能状态良好，国际骨与软组织肿瘤协会（MSTS）肢体功能评分平均为24．8分（19~28分）。结论长骨骨干肿瘤大段广泛切除和节段型骨干假体保肢重建是治疗骨干肿瘤的有效手术方案之一。设计定制假体能够确保手术切除至安全外科边界，降低术后局部复发率，并保留正常关节及周围软组织，使患者术后即可负重锻炼，提高了术后生活质量。

Segmental intercalary diaphyseal endoprosthetic reconstruction for bone tumor in the humeral diaphysis

Objective To discuss the feasibility and surgical methods and evaluate the therapeutic effects of segmental intercalary diaphyseal endoprosthetic reconstruction for diaphyseal defects following the resection of humerus diaphysis tumors. Methods We retrospectively studied the surgical strategies of six patients with humerus diaphysis tumors, including 2 bone cyst, 2 bone metastases of lung cancer, I aneurysmal bone cyst and I giant cell fibrotic lesion treated with segmental intercalary diaphyseal endoprosthetie reconstruction from April 2008 to June 2012. They were 2 males and 4 females, and the average age was 50. 8 years old （19-74 years old）. Results The average follow up was 29. 5 months （8-58 months）. In the latest follow-up, one patient died 20 months after the surgery and the others survived. All patients obtained limb function. The average score of Musculoskeletal Tumor Society （MSTS） functional scoring system was 24. 8 （19-28）. No patient had tumor local recurrence or prosthetic loosening. Conelmions The segmental intercalary diaphyseal eodoprosthetic reconstruction is one of the effective surgery treatments for the diaphyseal defects following the resection of humerus diaphysis tumors. Custom made prosthesis can ensure the secure surgical margins, further reduce the local recurrence rate and preserve the normal periartieular soft tissue. By means of that, patients can have rehabilitation exercise as early as possible, which improves their living quality.