• 1. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;
  • 2. SectionⅠDepartment of Orthopedics, the Fourth People’s Hospital of Zigong City, Zigong Sichuan, 643000, P.R.China;
  • 3. Department of Osteopathy, Sichuan Provincial Orthopedic Hospital, Chengdu Sichuan, 610041, P.R.China;
  • 4. Department of Orthopedics, Sichuan Provincial Fifth People’s Hospital, Chengdu Sichuan, 610031, P.R.China;
DUAN Hong, Email: duanhong1970@126.com
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Objective To investigate the procedure and effectiveness of total femoral replacement for treating femur malignant tumor.Methods The clinical data of 9 patients with femoral malignant tumors who underwent total femoral replacement between July 2013 and March 2017 were retrospectively analyzed. There were 5 males and 4 females, aged 16-75 years with an average of 44.8 years. The disease duration ranged from 2 to 6 months with an average of 3.5 months. There were 5 cases of osteosarcoma (3 cases were staged as Enneking ⅡB, 2 cases were staged as Enneking Ⅲ), 1 case of malignant fibrosarcoma (staged as Enneking ⅡB), 1 case of chondrosarcoma (staged as Enneking ⅠB), 2 cases of femoral muti-metastasis of lung cancer with pathological fracture. The visual analogue scale (VAS) score and the quality of life (QOL) score of the tumor patients were evaluated before operation and at 3 months after operation. The Musculoskeletal Tumor Society (MSTS) score and Harris hip score (HHS) were evaluated at last follow-up.Results Nine patients were followed up 11-58 months, with an average of 21 months. No complication such as wound infection, joint dislocation, and nerve injury occurred. One patient developed popliteal vein thrombosis, and 2 patients with osteosarcoma died of tumor progression. The VAS score and QOL score at 3 months after operation were 3.2±1.2 and 40.6±5.4 respectively, which were significantly improved when compared with preoperative ones (5.9±0.8 and 22.3±4.2 respectively) (t=11.314, P=0.000; t=–7.794, P=0.000). At last follow-up, the MSTS score was 15-29 with an average of 21.1, and the HHS score was 44-90 with an average of 66.5.Conclusion Total femoral replacement is an effective limb salvage procedure for the treatment of femoral malignant tumors, which can effectively restore the weight-bearing and walking function, relieve pain, and improve the quality of life.

Citation: WU Fan, FANG Xiang, LANG Zhigang, LIU Hongyuan, XIONG Yan, ZHANG Wenli, LUO Yi, TU Chongqi, DUAN Hong. Total femoral replacement for treating femur malignant tumor. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(1): 18-22. doi: 10.7507/1002-1892.201807052 Copy

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