Rompe J D, Eysel P, Hopf C, Heine J
Department of Orthopedics, Johannes Gutenberg-University Hospital, Mainz, Germany.
Arch Orthop Trauma Surg. 1994;113(5):260-4. doi: 10.1007/BF00443814.
A retrospective study was performed of the surgical treatment of metastatic lesions of the proximal femur in 50 patients. In 25 consecutive cases a megaprosthesis was implanted; compound plate osteosynthesis was performed in another 25 consecutive patients. Indications for surgical treatment were pathological fractures or, for prophylactic treatment, lesions of the femoral cortex exceeding 2.5 cm in diameter or affecting half the diameter of the bone or more. In all patients capable of walking preoperatively mobility was regained. Immediate full weight-bearing stability was obtained in all patients. Group analysis showed that the functional rating of the hip joint was unchanged, i.e., good or excellent, in all patients with compound osteosynthesis, compared to only 68% in the endoprosthesis group. Pain relief was excellent or good in 84% and 88% respectively. Dislocation of the tumor prosthesis occurred in 3 patients. Closed reduction was possible in 2 cases. Local recurrence was higher in the patients undergoing plate osteosynthesis, as was the frequency of tumor-related implant failure. Postoperative survival averaged 14.7 months and 12.1 months respectively.
对50例股骨近端转移性病变的手术治疗进行了回顾性研究。连续25例患者植入了巨型假体；另外25例连续患者进行了复合钢板接骨术。手术治疗的指征是病理性骨折，或者对于预防性治疗，股骨皮质病变直径超过2.5 cm或累及骨直径的一半或更多。所有术前能够行走的患者均恢复了活动能力。所有患者均获得了立即完全负重稳定性。组间分析显示，所有接受复合接骨术的患者髋关节功能评级未变，即良好或优秀，而假体植入组仅为68%。疼痛缓解分别为84%和88%，优秀或良好。3例患者发生肿瘤假体脱位。2例可行闭合复位。钢板接骨术患者的局部复发率较高，与肿瘤相关的植入物失败频率也较高。术后平均生存期分别为14.7个月和12.1个月。
