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[髋关节和股骨近端对骨盆的部分置换。肿瘤治疗中的一种可能性]

[Partial replacement of the pelvis with the hip joint and proximal femur. A possibility in tumor treatment].

作者信息

Dahmen G, Heise U

出版信息

Z Orthop Ihre Grenzgeb. 1985 May-Jun;123(3):265-72. doi: 10.1055/s-2008-1045148.

Abstract

In cases of extensive destructive osteolytic processes in the pelvis and hip region, alloplastic replacement of a part of the pelvis with a total hip replacement and, if necessary, partial replacement of the femur, can represent a therapeutic alternative to hemipelvectomy for preserving the limb in the presence of malignancies; it offers the same degree of radicality in removing the affected bone and soft tissue while preserving the bone. This applies with regard both to primary malignant growths as well as extensive isolated metastases and aseptic osteolysis following multiple total replacement procedures. The partial pelvic prostheses, produced individually on the basis of roentgenograms, are adapted to a great degree intraoperatively and fixed with screws, locknuts, and Palacos, and if possible lined with autogenous bone. Where the defects are extensive the pubic bone of the unaffected side is incorporated in the stabilization. Experience gathered so far and follow-up examinations show that all patients regain full mobility and weight-bearing ability, with almost complete lack of complaints and adequate to good motility. This is demonstrated by examples.

摘要

在骨盆和髋部区域出现广泛的破坏性溶骨过程的病例中,用全髋关节置换术对骨盆的一部分进行异体置换,必要时对股骨进行部分置换,对于在存在恶性肿瘤的情况下保留肢体而言,可作为半骨盆切除术的一种治疗替代方案;它在去除受影响的骨骼和软组织同时保留骨骼方面具有相同程度的根治性。这适用于原发性恶性肿瘤以及广泛的孤立性转移瘤和多次全置换手术后的无菌性骨溶解。基于X线片单独制作的部分骨盆假体,在很大程度上可在术中进行调整,并通过螺钉、防松螺母和骨水泥固定,如有可能,内衬自体骨。在缺损广泛的情况下,将未受影响一侧的耻骨纳入稳定结构。目前积累的经验和随访检查表明,所有患者均恢复了完全的活动能力和负重能力,几乎没有不适主诉,活动度良好。以下举例说明。

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