Objective:To evaluate the clinical feasibility of particle impaction bone graft and plate internal fixation for the treatment of proximal femoral bone tumors or tumor disease. Methods:From January 2013 to January 2016 a total of 26 cases of the proximal femur bone tumors or tumor lesions,neither pathological fracture,were retrospectively analyzed,including 12 males and 14 females with an average age of 34.2 years old ranging from 8 to 62 years old. The pathologic result involved fi-brous dysplasia in 11 cases,bone isolation bone cyst in 7 cases,giant cell tumors of bone in 3 cases,aneurysm sample bone cyst in 3 cases,non ossifying fibroma in 1 case,benign fibrous histiocytoma in 1 case. No biopsy of the lesion was performed before the operation. Postoperative lesions were sent to pathology. The operation was treated by particle impaction bone graft and plate internal fixation. Results:All patients were followed up to resume normal life for 8 to 42 months with an average of 25 months. The function assessment referenced to the bone and soft tissue tumor association (MSTS). At the end of the last exami-nation,the positive and lateral X-ray films of the femur showed no low density shadow in the margin of bone graft and bone graft,and the bone healing in the bone graft area was good. No recurrence or metastasis was found in all patients ,and no loos-ening or deformation of the internal fixator occurred. The hip function was well restored and no fracture or deformity progressed in all patients. Conclusion:The tumor recurrence in the proximal femur is related to curettage and bone grafting. After the curettage,the residual tumor cells were treated by chemical and physical methods. By this method,the disease can be cured for a long time,and it can reduce the recurrence and resume the function of the hip joint.%目的:评价颗粒打压植骨辅钢板内固定治疗股骨近端骨肿瘤或瘤样病损的临床可行性.方法:2013年1月至2016年1月治疗股骨近端骨肿瘤或瘤样病损26例,均未发生病理性骨折,男12例,女14例;年龄8~62岁,平均34.2岁.病理结果:纤维结构不良11例,骨孤立性骨囊肿7例,骨巨细胞瘤3例,动脉瘤样骨囊肿3例,非骨化性纤维瘤1例,良性纤维组织细胞瘤1例.术前未进行病灶活组织检查,术后送慢病理,手术采取颗粒打压植骨辅钢板内固定.结果:26例均随访至恢复日常生活,随访时间8~42个月,平均25个月.参照骨与软组织肿瘤协会(MSTS)进行功能评估.术后末次复查股骨正侧位X线片,植骨边缘及植骨体部未见低密度影,植骨区骨愈合良好,所有患者未见复发及转移病灶,内固定物无松动、变形.髋关节功能恢复良好,所有患者无再骨折和畸形进展.结论:股骨近端肿瘤复发与病灶刮除植骨技术有关,刮除后采用化学、物理方法处理消灭残留的肿瘤细胞,利用此方法可以获得疾病的长期治愈,减少复发,恢复髋关节功能.
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