The preliminary report of intercalary diaphyseal endoprosthetic reconstruction for the proximal femur malignant bone tumor

Abstract

Objective To evaluate the clinical effectiveness of the treatment for the proximal femur malignant bone tumor by conducting intercalary diaphyseal endoprosthetic reconstruction. Methods Form June 2011 to July 2014, 7 patients who had proximal femur malignant bone tumor were treated with intercalary diaphyseal endoprosthetic reconstruction. There were 3 males and 4 females, 61.8 years old on the average (ranging from 28 to 76 years). The tumors involved: 4 case of the limbs primary malignant tumor, 1 case of osteosarcoma, 1 case of juxtacortical osteosarcoma, 1 case of malignant lymphoma with pathological fracture, and 1 case of malignant fibrous histiocytoma with pathological fracture, as well as 3 cases of the Metastatic breast cancer of the proximal femur. All patients were evaluated by plain radiography, CT and MRI before operation. After these 7 patients were examined with MRI and the level of osteotomy was determined, prosthesis fitting is ready. The exposures of all the tumors were via the femur lateralis surgical approach. According to the general principles of tumor surgery, expose the tumor segment and soft tissue tumors. The segment of involved bone was then removed, with a surrounding cuff of normal tissue overlying the tumor. The level of osteotomy was determined as the result of preoperative imaging measurement. The proximal and distal femur intramedullary canals are reamed. The prosthesis is assembled and installed after the cement used. Results The duration of surgery was from 45 min to 120 min (90 min on average). The blood loss was from 200 ml to 800 ml (400 ml on average). All patients were followed-up for 6 months to 2 years (14 months on average). 1 case with osteosarcoma died due to pulmonary metastases 18 months after surgery. The remaining 3 cases with the primary malignant bone tumors did not recur or transfer during the follow-up period. 1 case with the metastases was comprehensive treated in another hospital, and survival with tumors. The remaining 2 cases with the metastases did not recur or transfer during the follow-up period. Conclusion The clinical results demonstrated that the intercalary diaphyseal endoprosthetic reconstruction was an ideal treatment for the proximal femur malignant bone tumor. Key words: Femur; Neoplasms; Prostheses and implants