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肿瘤型人工全膝关节假体置换术(1)
http://www.100md.com 2012年1月15日
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    参见附件。

     肿瘤型人工全膝关节假体置换术

    治疗严重成人股骨远端非骨化性纤维瘤

    张 东

    四川省内江市第二人民医院骨科,四川内江 641000

    [摘要] 目的 探讨肿瘤型膝关节假体置换术治疗成人非骨化性纤维瘤的临床疗效和应用价值。 方法 采用膝关节定制型肿瘤假体置换术治疗严重成人股骨远端非骨化性纤维瘤12例,手术均在气管插管全身麻醉下进行,采用仰卧位,行膝关节定制型肿瘤假体置换术。 结果 术后12例全部获得随访,随访6~32个月,平均18个月。疼痛完全消失,活动良好,未出现假体断裂、松动及脱出,无血管、神经损伤等并发症。 结论 肿瘤型膝关节假体置换术治疗成人非骨化性纤维瘤,患者疼痛完全消失,可早期下床活动,避免了病理性骨折和植骨融合失败,为一积极有效的方法。

    [关键词] 非骨化性纤维瘤;疼痛;膝关节;假体

    [中图分类号] R738 [文献标识码] A [文章编号] 1673-7210(2012)01(b)-067-02

    Tumorous type artificial total knee joint prosthetic replacement in treatment of severe adult distal femoral non-ossifying fibroma

    ZHANG Dong

    Department of Orthopedics, the Second People's Hospital of Neijiang City, Sichuan Province, Neijiang 641000, China

    [Abstract] Objective To investigate the clinical effects and application value of tumorous type artificial total knee joint prosthetic replacement in the treatment of severe adult distal femoral non-ossifying fibroma. Methods 12 patients with severe adult distal femoral non-ossifying fibroma received the treatment of knee joint customized tumor prosthetic replacement. All the operations were performed under general anesthesia by tracheal intubation in the supine position with knee joint customized tumor prosthetic replacement. Results All patients received postoperative follow-up for 6 to 32 months, with an average of 18 months. The pain completely disappeared and the motion was good. There was no appearance of prosthesis fracture, loosening and prolapse, and no appearance of blood vessels, nerve damage and other complications. Conclusion Tumorous type artificial total knee joint prosthetic replacement in the treatment of severe adult distal femoral non-ossifying fibroma can relieve the patients′ pain completely, provide early ambulation and prevent pathological fracture and bone graft fusion failure, therefore it is a positive and effective method.

    [Key words] Non-ossifying fibroma; Pain; Knee joint; Prosthesis

    非骨化性纤维瘤(non-ossifying fibroma,NOF)是一种少见的纤维组织肿瘤[1]。1942年Jaffe和Lichtenstein认为它是一种真性肿瘤,3年后Hatcher认为它是干骺端纤维缺损[2]。实质上它是一种瘤样病损,又称干骺端纤维性骨皮质缺陷病,但目前则又认为这种病变与纤维组织细胞瘤在病理上难以区分。病灶内含有多核巨细胞,以长管状骨的干骺端皮质处较常见,年龄多在8~18岁[3]。但严重成人股骨远端非骨化性纤维瘤少见。过去治疗采用单纯刮出植骨内固定手术,存在植骨不融合、卧床时间长等缺点。2002年1月~2010年12月我院采用肿瘤型人工全膝关节定制型肿瘤假体置换术治疗严重成人股骨远端非骨化性纤维瘤12例,疗效满意,报道如下:

    1 资料与方法

    1.1 一般资料

    本组12 例患者,男8例,女4例, 年龄35~56 岁 ......

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