Neer型人工肩关节置换治疗肱骨近端恶性肿瘤  

Treatment of malignant bone tumors of proximal humerus by the replacement of Neer artificial shoulder joint

作　　者：樊健[1] 俞光荣[1] 袁锋[1] 周家钤[1] 叶萍[1] 

机构地区：[1]同济大学附属同济医院骨科,上海200065

出　　处：《生物骨科材料与临床研究》2013年第5期51-53,共3页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨Neer型人工肩关节置换治疗肱骨近端恶性肿瘤的临床效果。方法对8例肱骨近端恶性肿瘤行肿瘤瘤段切除、Neer型人工肩关节置换治，术后进行肩关节功能训练。评估术后患者的生存时间、病灶复发转移情况及假体情况，按照Neer肩关节功能评分标准对术后肩关节进行功能评分。结果8例患者术后全部获随访，平均随访3．8年（8-57个月）。其中2例骨肉瘤患者中，1例因肺转移于术后1．5年死亡，另1例存活至今，2例平均生存时间3．5年。其余患者均存活至今，平均存活时间4．8年，但1例局部复发，再行1／4截肢后至今无瘤生存。术后x线至最后一次随访未发现假体松动及断柄等并发症。按照Neer肩关节功能评分标准，优2例，良3例，中l例，优良率为83．3％。结论用Neer型假体治疗肱骨上段恶性肿瘤可保留患肢的形态，能恢复上肢的大部分功能，是一种值得肯定的方法。Objective To discuss the treatment of malignant bone tumors of proximal humerus by the replacement of Neer artificial shoulder joint, Methods 8 patients with malignant bone tumors of proximal humerus were treated with seganental resection and Neer prosthetic replacement of shoulder joint and taken planned shoulder function training postoperativly. Evaluate postoperative survival time, lesion recurrence and metastasis, and the prosthesis of patients. Reusults All patients were followed-up for averaged 3.5 years （from 8 months to 57 months）. Among 2 cases of Osteosarcoma, 1 cases has been survival, with an average survival time of 3.87 years, 1 case of pulmonary metastasis died after 2 years. Chondro-sarcoma and malignant giant cell tumor of hone has been survival with an average survival time of 4.8 years, and 1 cases of local recurrence, a further 1/4 of amputation-free survival to date, no prosthesis stem loosening and breaking occurred, according to Neer shoulder function score standards, excellent in 2 cases, good in 3 cases, fair in 1 case and good rate of 83.3%. Conclusion It can be evidented that prosthetic replarement of shoulder joint for the reatment of malignant tum-ors of proximal humerus would not only keep the integrated appearance, but also preserve the function of the upper ex tremity to a greater extent

关 键 词：肱骨上段 恶性骨肿瘤 Neer假体 置换 

分 类 号：R738[医药卫生—肿瘤]