人工肱骨头假体在治疗肱骨近端骨肿瘤中的应用

Application of artificial humeral head prosthesis in the treatment of proximal humerus bone tumor

目的 探讨人工肱骨头假体在肱骨近端骨肿瘤治疗中的临床应用效果。方法回顾性分析15例行骨肿瘤切除和人工肱骨头假体置换术肱骨近端骨肿瘤患者，其中骨肉瘤8例，骨巨细胞瘤4例，软骨肉瘤2例，纤维肉瘤1例。结果术后随访平均（394-5）个月，手术时间平均（110±10）min，术中出血平均（600±41）ml。1例骨肉瘤患者于术后20个月死于复发伴全身多处转移，余14例按Enneking评分标准，末次随访时评分（23．34-3．7）分，总体优良率为84．6％（11／15）。结论采用人工肱骨头假体能有效地治疗肱骨近端骨肿瘤，具有良好的近期临床效果。

Objective To evaluate the clinical effects of the artificial humeral head prosthesis in the treatment of proximal humerus bone tumors. Methods Fifteen patients with proximal humerus bone tumor had excision of bone tumor and application of artificial humeral head prosthesis were analyzed retrospectively. Among them,8 patients had osteosareoma, 4 patients had giant cell tumor of bone, 2 patients had chondrosarcoma, 1 patient had fibrosarcoma. Results All cases were followed up for average （39 ± 5 ） months after the surgery. The duration time of operation were（ 110 ±10） minutes in average. The bleeding volume during operation were （600 ±41 ） ml in average. One patient with osteosarcoma died of recurrence and metastasis 20 months after the surgery. The functions of the other 14 patients were assessed by Enneking system and the average score was 23.3 ± 3.7. The overall rate of excellent or good results was 84.6% （ 11/15 ）. Conclusion Limb salvage surgery with the artificial humeral head prosthesis is an efficacious treatment for proximal humerus bone tumors, which can improve short-term clinical outcome.