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目的正确认识肢体肿瘤所致病理性骨折的概念和病因,掌握早期诊断与鉴别诊断方法,减少误诊、误治,提高治疗效果.方法1981年门月~1997年10月共收治肢体肿瘤所致病理性骨折患者162例,其中良性肿瘤与肿瘤样病损85例,恶性肿瘤77例.治疗原则:良性肿瘤行刮除植骨,根据不同情况分别采用张力带钢丝、钢板螺钉、石膏以及单臂外固定架进行固定.恶性肿瘤要在配合化疗和放疗基础上分别采用肿瘤段切除灭活再植、开创放疗、异体半关节移植,对于无保肢条件者实行截肢.结果162例病理性骨折经过上述治疗均能愈合.以良性骨肿瘤与肿瘤样病损作为原发病的85例术后10个月内复发4例;10~12个月复发21例;1~5年复发12例.恶性骨肿瘤77例的两年生存率为78％,五年生存率为42％.结论肢体肿瘤所致病理性骨折的治疗并不困难,关键是原发病的早期诊断与鉴别诊断.诊断时要认真询问病史和受伤机制,骨折前有夜间痛、轻度外伤就出现骨折要想到肢体肿瘤所致病理性骨折的可能.“,”Objective To describe the concept and etiology of the pathological fractures caused byextremity bone tumors and their diagnosis and differential diagnosis to improve the outcome. Methods Between December 1981 and October 1997, 162 patients with pathological fracture caused by extremity bonetumors were treated. The pathology could be classified as benign bone tumors and tumor-like lesions in 85cases and malignant.bone tumors in 77. Various methods of internal and external fixation were used accordingto the type of the fracture. For the benign bone tumors, additional curettage and hone grafting were performed.For the malignant hone tumors, chemotherapy and radiotherapy were used in addition. ResultS Through theinternal or external fixation, primary healing of fracture was achieved. The local recurrence within I year wasseen in 25 patients and within 5 years in 12 out of 85 patients with benign bone tumors. Among the 77 patientswith malignant bone tumors, two years survival rate was 78% and five years survival rate 42%. ConclusionEarly and differential diagnosis of the primacy lesions is vitally imPOrtant for surgical management of thepathological fractures caused by extremity bone tumors. Careful investigation of the history and injury mechanism is necesseq for the diagnosis. Night pain before fracture and the fracture caused by mild force remind thesurgeon the possibility of a pathological fractures.