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股骨转移性骨肿瘤的骨骼重建手术结果

Outcome of Skeletal Reconstructive Surgery for Metastatic Bone Tumours in the Femur.

作者信息

Mohamed-Haflah N H, Kassim Y, Zuchri I, Zulmi W

机构信息

Department of Orthopaedics, Universiti Kebangsaan Malaysia, Cheras, Malaysia.

Department of Orthopaedics, Prince Court Medical Centre, Kuala Lumpur, Malaysia.

出版信息

Malays Orthop J. 2017 Mar;11(1):28-34. doi: 10.5704/MOJ.1703.013.

Abstract

INTRODUCTION

The role of surgery in skeletal metastasis is to reduce morbidity and improve the quality of life in terminally ill patients. We report our experience with patients who underwent skeletal reconstructive surgery for metastatic bone tumour of the femur.

MATERIALS AND METHODS

Twenty nine operations for skeletal metastasis of the femur performed in our centre between 2009 and 2015 were included in this study. We evaluated the choice of implant, complications, survival rate and functional outcome. Fourteen patients were still alive at the time of this report for assessment of functional outcome using Musculoskeletal Tumour Society (MSTS) form.

RESULTS

Plating osteosynthesis with augmented-bone cement was the most common surgical procedure (17 patients) performed followed by arthroplasty (10 patients) and intramedullary nailing (2 patients) There were a total of five complications which were implant failures (2 patients), surgical site infection (2 patients), and site infection mortality (1 patient). The median survival rate was eight months. For the functional outcome, the mean MSTS score was 66%.

CONCLUSION

Patients with skeletal metastasis may have prolonged survival and should undergo skeletal reconstruction to reduce morbidity and improve quality of life. The surgical construct should be stable and outlast the patient to avoid further surgery.

摘要

引言

手术在骨骼转移瘤治疗中的作用是降低晚期患者的发病率并提高其生活质量。我们报告了对因股骨转移性骨肿瘤接受骨骼重建手术患者的治疗经验。

材料与方法

本研究纳入了2009年至2015年间在我们中心进行的29例股骨骨骼转移瘤手术。我们评估了植入物的选择、并发症、生存率和功能结果。在撰写本报告时,14名患者仍存活,使用肌肉骨骼肿瘤学会(MSTS)表格对其功能结果进行评估。

结果

带增强骨水泥的钢板内固定术是最常见的手术方式(17例患者),其次是关节置换术(10例患者)和髓内钉固定术(2例患者)。共有5例并发症,包括植入物失败(2例患者)、手术部位感染(2例患者)和手术部位感染导致的死亡(1例患者)。中位生存率为8个月。关于功能结果,MSTS评分的平均值为66%。

结论

骨骼转移瘤患者可能有更长的生存期,应接受骨骼重建以降低发病率并提高生活质量。手术结构应稳定且在患者生存期内保持良好,以避免再次手术。

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