| Objective:to analyze the short-term efficacy and prognosis of surgical treatment of proximal femoral tumors.Methods:(1)The selection of the cases: Selected the hospitalized cases which met the standards of our hospital, focused on the femoral proximal tumor patients between May 2005 to May2015 in the hospital for surgical treatment, collected patients’ records and image data,followed up patients regularly after operations;(2)Treatment:To those patients who were suffering proximal femoral tumor,according to their condition and experience,opened or punctured biopsies or did further treatment based on the examination results of the fast frozen sections.Patients whose pathological examination results were reported as benign lesions were given more lesions curettage of implantation of autologous bone or bone allograft, residual cavity processing, repair of bone defects,(fixed hollow screws and dynamic hip screw(DHS) etc.];Patients whose pathological examination results were malignant lesions were given more wide resection of the artificial prosthesis replacement method. After the operation, all the patients were treated with routine pathological examination to make a definite diagnosis and to provide the basis for the future treatment.(3)Evaluation of curative effect and follow-up: Observed the local symptom remission status and the activity of the lower limbs function carefully after operation;Collected patients relevant information strictly before the operation and told postoperative patients to take regular review(local X-ray, CT), ran follow-up, Contrasted preoperative examination with postoperative effect and observed patients after the operation. Followed up respectively to the patients who hadn’t had tumors for 6 months, 1 year, 2 years, 3 years, 5years and analyzed the survival rates and postoperative recurrence of the lesion and the limb function recovery, then according to Eneeking of limb function scores gave a score and analyzed the clinical curative effect of the surgical treatment of proximal femoral tumors.The Result:There were 92 patients in this study, 51 were male, 41 were female, ages were from 11 to 70, average age was 39.6, including 73 cases of benign bone tumors or tumor like lesions, 14 cases of bone cysts, 30 cases of fibrous dysplasia, 10 cases of aneurysmal bone cyst, 4 cases of endogenous chondroma in, 6 cases of osteoid osteoma, 4 cases of osteoblastoma, pathological fracture with total 28 cases, 5 cases of giant cell tumor of bone; 19 cases of malignant tumors: 4 cases of chondrosarcoma, 8 cases of osteosarcoma,2 cases of Ewing’s sarcoma, 2 cases of malignant fibrous histiocytoma, 3 cases of metastatic tumor. For the patients with benign tumors, 8 cases were lost to follow up, 60 cases of follow-up(3 months to 5 years after surgery),the average is 31 months, both were disease-free survival; there were 3 cases of local recurrence in 30 cases of fibrous dysplasia(10.0%), 1 case of recurrence in 5 patients with giant cell tumor of the bone(20%), 2 cases with an interview with disease-free survival. In 19 cases of malignant tumor patients,follow-up time were 3 months to 5 years,average 32 months, 4 patients were lost to follow up, 8 cases(42.2%) died, among them 4 cases(21.1%) died of lung metastasis, 4 cases(21.1%) died of local recurrence, 7 patients(36.8%) were disease-free survival;Conclusion:There were so many types of proximal femur tumors, for patients with benign tumors,lesion scrapings, lesion area destroy live bone graft and selective treated with internal fixation were satisfactory and the recurrence rate was low; for patients with malignant tumors, underwent wide excision with prosthetic replacement could make the patients recovery their walking function in a short term, so that restored their confidence, improved their life quality and updated their life cycle. |
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