Abstract:Objective To investigate the clinical efficacy of two different surgical methods in the treatment of pathological fractures with bone metastases in the subtrochanteric region of the femur.Methods Retrospective analysis was performed on 32 patients with subtrochanteric bone metastatic tumor who received surgical treatment in our hospital from January 2013 to January 2020,including 15 males and 17 females,aged 44 to 77 years old,with an average age of (60.84±8.16) years old.There were 7 cases of near fracture and 25 cases of pathological fracture.The surgical plan was made according to the Mirls score.The Mirls score was more than 8 points,and the surgical treatment was performed.Fifteen cases were treated with intramedullary nailing combined with bone cement after curettage,and 17 cases were treated with tumor segmentectomy and artificial weight reconstruction.All all have the same set of performer to complete the surgery,comparative analysis of two groups of patients with general statistical analysis of clinical data and curative effect evaluation index pain visual analogue scale (VAS) were used respectively to assess pain,Karofsky fitness score (KPS) evaluation of fitness,bone and soft tissue tumor association (MSTS) score evaluation,limb function after surgery for followup record local recurrence and survival.Results The follow-up time of 32 patients ranged from 4 to 25 months,with an average of (14.23±1.32) months.VAS scores,KPS scores and MSTS scores at 1 and 3 months after surgery were significantly improved compared with those before surgery,and the differences were statistically significant (P<0.05).During follow-up,26 patients died,and the postoperative survival time was (12.61±1.97) months in the artificial prosthesis group and (15.89±1.72) months in the intramedullary nail group.There was no significant difference in postoperative survival time between the two groups (P>0.05).In all patients up to the last follow-up,6 patients in the intramedullary nail group had local lesion recurrence,but no tumor prosthesis group.There were no perioperative or postoperative complications such as loosening,fracture,peripheral infection and recurrence of fracture.Conclusion Both of the two surgical methods can effectively relieve pain,restore limb function,improve life quality,and reduce the incidence of complications.The fixation of intramedullary nail is beneficial to the early subsoil activity,and the establishment of tumor prosthesis is beneficial to the local control of tumor.
张旭 1,施建党 2*,牛宁奎 2,刘昌昊 1,李凯歌 1,杨宗强 2. 两种术式治疗股骨转子下区骨转移瘤的临床疗效[J]. 实用骨科杂志, 2020, 26(11): 970-1014.
Zhang Xu 1,Shi Jiandang 2*,Niu Ningkui 2,et al. Efficacy of Two Surgical Methods in the Treatment of Bone Metastases in the Subtrochanteric Region of Femur. sygkzz, 2020, 26(11): 970-1014.
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