81例四肢病理性骨折的外科治疗  

The surgical treatment for pathologic fractures in 81 cases

作　　者：黄纲[1] 符气祯[1] 尹军强[1] 

机构地区：[1]中山大学第一附属医院骨肿瘤科,广州510080

出　　处：《中华关节外科杂志（电子版）》2007年第5期281-283,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的总结分析病理性骨折的临床治疗方法及其合理性。方法回顾性分析2003年6月至2006年6月中山大学第一附属医院骨肿瘤科手术治疗四肢病理性骨折81例。统计分析病理性骨折的不同病因特点,临床特征及采用不同临床治疗方法的必要性和合理性。结果病理性骨折发生于8～74岁不同年龄的患者,平均年龄38.6岁。骨折病因依次为转移性肿瘤32例(39.6%),原发恶性肿瘤27例(33.4%),良性肿瘤22例(27.2%);下肢57例(70.4%),上肢24例(29.6%);29例(35.8%)合并有肺或其他部位转移。81例均接受手术治疗,术后随访时间6～36个月,平均32个月。76例(93.8%)术后能扶拐行走,其中45例(55.6%)3个月后正常行走,6例(7.3%)1年内死亡,13例(16.1%)3年内死亡。结论病理性骨折为临床常见病,不同病因有不同临床特征及应采用不同的治疗方法;掌握其不同临床特点,采用合理、优良有效的治疗方法是良好预后的关健。Objective To investigate the treatment protocols for pathological fracture. Methods Eighty one patients with pathological fracture were treated in the Affiliated First Hospital, Sun Yat-sen University hospital between Jun, 2003 and Jun, 2006. We investigated the etiological factors, clinical features and therapy protocols in these cases. Results The average age of the patients with pathological fractures was 38.6 （8 - 74 ） years old. The etiological factors including 32 cases （39.6%） of the metastatic tumors, 27cases（33.4% ）of the primarily malignant tumors and 22 cases （27.2%） of the benign tumors; 57 cases （70.4%） was involved in the lower limbs, 24 cases （29. 6% ）was involved in the upper limb. 29 cases （35.8%） had presented with metastases. All the patients were underwent surgical treatment and followed- up （6 - 36 months, mean 32 months）. After treatment,76 cases （93.8%） could walk with the cruch and 45 cases could walk （55.6%） normally after 3 months. 6 cases（7.3% ） were died in 1 year and 13 cases （16. 1% ）were died in 3 years. Conclusion The pathological fracture was the common disease in clini- cal practice. Different causes had different features and different treatment protocols. Reasonable and effective treatment was the key factor for the prognostic outcome in pathological fractures.

关 键 词：四肢 骨折 自发性 治疗 

分 类 号：R687.3[医药卫生—骨科学]