摘要
目的报告1例采用带锁套筒式髓内假体治疗股骨下端骨肉瘤病人行肿瘤切除人工关节置换术后3.5年,股骨上段皮质出现广泛溶解、吸收、变薄,下端折断、破碎,肢体变短的病例。方法保留股骨上端与髋关节结构和功能,重新制作带锁套筒式髓内假体,与原来人工关节组合成新的假体,穿过股骨上段,嵌入粗隆部松质骨内,并打入股骨颈锁钉。新假体表面涂有羟基磷灰石与变薄骨质紧密相邻,在粗隆部和新假体下方植骨,期待骨愈合后完成生物学重建和上段股骨修复。结果成功进行翻修术,3个月后随诊患者步态正常,膝关节伸屈活动0。～100。。结论本假体设计制作构想和结构原理,可以借鉴于股骨上端在翻修术中清除骨水泥后髓腔变粗,皮质变薄不坚固的病例。
Objective To develop the interlocking tubular component for revision of meta-prosthesis in case of loosing and stem breaking. Methods One patient of distal femur osteosarcoma were treated with resection and mega-prosthesis replacement and loosing and stem breaking occurred three and half year postoperatively. The patient had obvious cortex thinning and limb shortening. For keeping the hip natural function, an interlocking tubular component were used for replacing the breaking stem. It was connected with the preprosthesis by cemented tubular and interlocking HAC coated stem fixed to the peritrochanter site with autografting. Results The revision operation was completed successfully. Normal gait and motion range （0 to 100 degree） were achieved after 3 months follow-up, Conclusions This kind of component could be applied for the revision cases whose medullary cavity widening and cortex thinning of proximal part of femur after removal of bone cement.
出处
《中国骨肿瘤骨病》
2008年第3期149-150,共2页
Chinse Journal Of Bone Tumor And Bone Disease
关键词
带锁套筒式髓内假体
皮质变薄
股骨上端
Interlocking tubular component
Cortex thinning
Proximal of femur
