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find Keyword "骨肿瘤" 102 results
  • BIPOLAR PROSTHETIC REPLACEMENT FOR PROXIMAL FEMORAL TUMORS

    Objective To evaluate the effectiveness of bipolar prosthetic replacement for proximal femoral tumors from the perspectives of patient survival, prosthesis survival, functional outcomes, and complication rates. Methods Between July 2001 and July 2010, 96 patients with proximal femoral tumors underwent wide resection and bipolar prosthetic replacement, including 83 cases of primary femoral tumors and 13 cases of soft tissue sarcomas involving the proximal femur. There were 50 male and 46 female patients with a mean age of 43.2 years (range, 15-69 years). Prosthetic replacement for proximal femoral tumors was used in 85 patients and deactivated bone-prosthetic complex was used in 11 patients. According to Enneking staging, the patients were divided into 3 groups: group A, 24 patients at stages IA, IB, and benign lesion; group B, 56 patients at stages IIA and IIB; and group C, 16 patients at stage III, myeloma, and lymphoma. The American Musculoskeletal Tumor Society 1993 version (MSTS93) functional score was used to evaluate the lower limb function. Results Primary healing of incision was obtained in 93 patients; 3 patients had poor healing, which was cured after debridement. Of the patients, 89 were followed up 6.5 years on average (range, 1-10 years). During follow-up, 28 patients died of tumor. The 5- and 10-year survival rates of patients were 100% in group A, and were 56.5% and 41.5% in group B respectively, and the 5-year survival rate was 18.4% in group C; there was significant difference among 3 groups (P lt; 0.01). The 5- and 10-year survival rates of prosthesis were 74.4% and 62.5%, which were significantly higher than those of patients in groups B and C (P lt; 0.01). Sixty-one patients were followed up 1-10 years (mean, 4.7 years) for functional evaluation. The mean MSTS93 score of the survival patients was 79% (range, 63%-95%) at last follow-up. Complications were observed in 15 patients (16.9%): hip dislocation in 2, delayed infection in 2, aseptic loosening in 8, severe acetabulum wear in 1, and hip pain in 2. Conclusion Bipolar proximal femoral prosthetic replacement for proximal femoral tumors can provide a satisfactory functional outcome, especially for tumors at stage II or III and myeloma and lymphorma patients. Revision is needed because of main late complications of aseptic loosening, hip pain, and acetabulum wear.

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 定制人工肱骨头假体置换治疗肱骨近端骨肿瘤的疗效

    目的总结定制人工肱骨头假体置换治疗肱骨近端骨肿瘤的临床疗效。 方法2005年1月-2011年10月,对16例肱骨近端骨肿瘤患者行瘤段切除及定制人工肱骨头假体置换治疗。男10例,女6例;年龄14~68岁,平均25.5岁。皮质旁骨肉瘤2例,软骨肉瘤2例,转移性平滑肌肉瘤1例,尤文肉瘤2例;根据Enneking分期:Ⅰb期4 例,Ⅱb期3例。侵袭性和复发性骨巨细胞瘤各3例,骨巨细胞瘤合并动脉瘤样骨囊肿3例;根据Campanicci分级:Ⅲ级7例,Ⅰ~Ⅱ级2例。病程2~28个月,平均11.6个月。除骨巨细胞瘤患者外均辅助给予术前1~2 个疗程、术后2~3个疗程正规化疗。 结果术后患者切口均Ⅰ期愈合,无感染等并发症发生。患者均获随访,随访时间12~81个月,平均38.6个月。X线片检查示,随访期间无假体感染、松动、断裂及假体周围骨折等并发症发生。术后12个月,肩关节功能采用肌肉骨骼肿瘤学会评分标准为16~29分,平均24.1分;获优11例,良3例,中2例,优良率达87.5%。1 例尤文肉瘤患者于术后22个月死于肺转移;1例骨巨细胞瘤患者于术后2年复发;其余患者均无肿瘤复发。 结论应用定制人工肱骨头假体置换治疗肱骨近端骨肿瘤能降低术后并发症,且肩关节功能恢复满意。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • CLINICAL APPLICATION OF ARTIFICIAL CONDYLAR PROCESS FOR RECONSTRUCTING TEMPOROMANDIBULAR JOINT

    【Abstract】 Objective To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Methods Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Results Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. Conclusion The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • APPLICATION OF POROUS TANTALUM IMPLANT IN TREATMENT OF BONE DEFECT

    【Abstract】 Objective To review the progress in the treatment of bone defect by porous tantalum implant. Methods Recent l iterature was extensively reviewed and summarized, concerning the treatment method of bonedefect by porous tantalum implant. Results By right of their unique properties, porous tantalum implants have achievedvery good results in the treatment of certain types of bone defects. Conclusion Porous tantalum implants have their ownadvantages and disadvantages. If the case is meet to its indications, this method can obtain a good effect. Porous tantalum implants provide a new way for the cl inical treatment of bone defects.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • PREVENTION AND CONTROL STRATEGIES OF COMMON POST-OPERATIVE COMPLICATIONS OF MICROWAVE ABLATION IN SITU IN TREATMENT OF BONE TUMORS

    Objective To analyze the common post-operative complications of microwave ablation in situ in the treatment of bone tumors and the prevention and control strategies. Methods Between March 2009 and July 2012, 73 cases of bone tumors were treated with microwave ablation in situ, of which 54 cases met the inclusion criteria. There were 31 males and 23 females with a median age of 27 years (range, 9-74 years), including 37 malignant tumors and 17 benign tumors. In 49 primary bone tumors, 17 cases were in stage 3, 13 in stage IIA, and 19 in stage IIB according to Enneking grading system. The postoperative complications, managements, and outcomes in patients were analyzed. Results After operation, 54 patients were followed up 12-40 months (mean, 24 months). Seven kinds of complications occurred in 21 patients (38.9%) with 3 cases suffered from more than one, including pathologic fracture in 4 cases (7.4%), deep infection in 2 cases (3.7%), nerve injury in 7 cases (13.0%), deep vein thrombosis of the lower extremity in 1 case (1.9%), medial collateral ligament heat injury of the knee in 1 case (1.9%), hematoma in 2 cases (3.7%), and fat liquefaction of incision and flap necrosis in 8 cases (14.8%). Conclusion Pathologic fracture is the primary complication which results in a second surgery. Deep infection is the main complication that often leads to failure of the limb salvage. Nerve injury and poor wound healing are the most common complications. Good control of microwave temperature is the key to successful operation, and the related preventive strategies could reduce complications.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • EFFECTIVENESS EVALUATION OF PROSTHETIC REVISION FOR ASEPTIC LOOSENING IN ONCOLOGY PROSTHESIS

    Objective To evaluate the effectiveness of prosthetic revision using custom-made long stem prosthesis and allograft-prosthesis composite (APC) for aseptic loosening after bone tumor resection. Methods Between January 2002 and June 2008, 14 patients with aseptic loosening after bone tumor resection were treated. There were 8 males and 6 females,aged 21-70 years (mean, 43.9 years). The locations were distal femur (8 cases), proximal femur (2 cases), and proximal tibia (4 cases). Pain of the affected l imb occurred after 6-31 years of prosthesis replacement and worsened when bearing and walking; 6 patients had shortened l imb. The functional results were assessed quantitatively according to the functional rating system of the Musculoskeletal Tumor Society (MSTS). The MSTS score was 16.36 ± 1.50 before revision. The X-ray films showed obvious prosthetic loosening and subsidence. The average time of symptom was 4.5 years (range, 3-9 years). In 7 patients having severe bone loss (the decrease of the thickness of cortical bone was more than 50%) and the prosthetic subsidence was more than 2 cm, the revision operation with the APC was performed; in 7 patients having less bone loss (the decrease of the thickness of cortical bone was less than 50%), the custom-made long stem prosthesis was performed. Results All wound healed by first intention. Two patients had temporary peroneal nerve paralysis and recovered after 3 months. All the patients were followed up 3.6 years on average (range, 2 years and 2 months-7 years) after revision. After revision, pain was rel ieved and the range of joint was improved. The MSTS score was 23.43 ± 2.56 at 12 months after revision showing significant difference when compared with the preoperative score (t=8.910, P=0.024). The X-ray films showed that lucency space l ine around stem cement in 2 patients at 12 months, and no prosthesis loosening and infection occurred. Conclusion The prosthetic revision after l imb salvage surgery with prosthesis for bone tumors was acceptable. The good functional results can be achieved by the revision with the APC or the custom-made long stem prosthesis according to the bone loss.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • APPLICATION OF TITANIUM PLATE AND Teflon PATCH IN CHEST WALL RECONSTRUCTION AFTER STERNAL TUMOR RESECTION

    Objective To study the reconstruction method and effectiveness of titanium plate and Teflon patch for the chest wall after resection of sternal tumors. Methods Between October 2006 and November 2009, 4 patients with sternal tumors were treated and the thoracic cages were reconstructed. There were 2 males and 2 females, aged 30-55 years. The patientswere admitted because of chest lump or pain. The sizes of palpable lump ranged from 4 cm × 3 cm to 10 cm × 8 cm. CT examination showed bone destruction. After sternal tumor resection, defect size ranged from 10 cm × 8 cm to 18 cm × 14 cm, and titanium plate and Teflon patch were used to repair and reconstruct the chest wall defect. Results The operations of the tumor resection and reconstruction of chest wall defect were successfully performed in 4 cases. Incisions healed by first intention with no abnormal breath, subcutaneous emphysema, pneumothorax, and infection. One case failed to be followed up after 6 months; 1 case died of intracranial hemorrhage; and 2 cases were followed up 1 and 4 years respectively without tumor recurrence. The chest wall had good remodel ing. No loosening and exposure of titanium plate, difficulty in breathing, chest distress, and chest pain were observed during followup. Conclusion Surgical resection of sternal tumors will cause large chest wall defect which can be repaired by titanium plate and Teflon patch because it had the advantages of easy operation, satisfactory remodel ing, and less compl ication.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • 人工全髋关节置换术治疗股骨近端骨肿瘤早期疗效

    目的 总结人工全髋关节置换术治疗股骨近端骨肿瘤的临床疗效。 方法 2000 年1 月- 2009 年6 月,采用广泛切除肿瘤后人工全髋关节置换术治疗17 例股骨近端骨肿瘤患者。男11 例,女6 例;年龄38 ~ 65 岁,平均52.6 岁。病程3 ~ 485 d,中位时间18 d。骨肉瘤2 例,软骨肉瘤2 例,骨转移性肿瘤3 例,骨巨细胞瘤6 例,动脉瘤样骨囊肿1 例,骨囊肿2 例,骨囊肿复发1 例。肿瘤大小范围为4 cm × 3 cm ~ 8 cm × 4 cm。 结果 患者手术时间100 ~ 180 min,平均138 min;术中输血量600 ~ 1 500 mL,平均923 mL;住院时间14 ~ 22 d,平均16.5 d。 术后切口均Ⅰ期愈合,无感染、脱位、脂肪栓塞、深静脉血栓形成发生。17 例均获随访,随访时间11 ~ 60 个月,平均47.4 个月。3 例骨转移性肿瘤、1 例骨肉瘤于出院后11 ~ 37 个月因肿瘤肝、肺转移死亡。术后1 年存活的16 例根据Harris 评分标准评定关节功能:获优5 例,良8 例,中2 例,差1 例。X 线片均未见肿瘤复发、髋臼磨损、髋关节脱位、假体松动与假体周围骨折。 结论 人工全髋关节置换术治疗股骨近端骨肿瘤早期疗效满意,可以重建髋关节功能,肢体功能恢复快,并发症少。

    Release date:2016-08-31 05:41 Export PDF Favorites Scan
  • 骶骨骨纤维结构不良一例报告

    详见正文

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • BIOMECHANICAL EFFECTS OF SACRECTOMY EXTENTS ON STABILITY OF LUMBO-ILIAC FIXATION USING ILIAC SCREW TECHNIQUES

    Objective To evaluate the effects of sacrectomy extent on the stabil ity of lumbo-il iac fixation using single or dual il iac screw technique, and to determine which conditions require the dual il iac screw technique. Methods Nine fresh L2 to pelvic specimens were harvested from donated adult cadavers. After testing the intact state simulated by L3-5 pedicle screw fixation, sequential partial sacrectomies and L3 to il iac fixation using bilateral single il iac screw (Single) wereconducted on the same specimen as follows: in group A, under S1 partial sacrectomy and Single; in group B, under 1/2 S1 partial sacrectomy and Single; in group C, one-side (left) sacroil iac joint resection and Single; in group D, total sacrectomy and Single; and in group E, the single il iac screw was replaced by dual il iac screws based on group D. Biomechanical testing was performed on a material testing machine under 0-800 N compression and —7-7 N•m torsion loading modes for construct stiffness evaluation. Results The compressive stiffness of intact condition was (392 ± 119) N/mm, groups A, B, C, D, and E obtained 106.4% ± 9.5%, 102.7% ± 8.0%, 92.2% ± 10.1%, 72.7% ± 8.0%, and 107.7% ± 10.7% of intact condition, respectively. No significant differences were found among groups A, B, C, and the intact state (P gt; 0.05), however, the four groups showed significantly higher compressive stiffness than group D (P lt; 0.05). Although group E exhibited a comparable compressive stiffness with groups A, B, and intact state (P gt; 0.05), it displayed markedly higher compressive stiffness than groups C and D (P lt; 0.05). The torsional stiffness of intact state was (3.22 ± 1.23) N•m/deg. Groups A, B, C, D, and E acquired 105.4% ± 10.1%, 89.8% ± 12.3%, 75.9% ± 10.6%, 71.2% ± 10.2%, and 109.1% ± 16.9% of intact state, respectively. No significant differences were detected among groups A, B, E, and the intact state (P gt; 0.05). However, groups C and D showed remarkably lower torsional stiffness than groups A, E, and the intact state (P lt; 0.05). Importantly, group E offered remarkably higher torsional stiffness than group B (P lt; 0.05). Conclusion After under 1/2 S1 partial sacrectomy, single il iac screw technique could effectively restore local stabil ity; whereas it could hardly provide adequate stabil ity for further resection of one-side sacroil iac joint or total sacrectomy; in such situation, the use of dual il iac screw technique could obtain sufficient construct stabil ity. Therefore, in the surgical treatment of sacral tumor, the dual il iac screw technique should be considered for the unstable conditions of totalsacrectomy or under 1/2 S1 sacrectomy with one-side sacroil iac joint resection.

    Release date:2016-08-31 05:47 Export PDF Favorites Scan
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