الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
The proximal femur is a common site for bone tumors whether primary or secondary. limb salvage has become the standard of care with variable options including endoprosthetic reconstruction, osteoarticular allograft or allograft prosthesis composite. Reconstruction using a tumor endoprosthesis has the advantages of early weight-bearing, immediate stability and good rapid functional recovery.Diagnosis of proximal femoral tumors includes: (a) Clinical examination including history taking and examination, (b) Imaging studies including: plain x ray, MRI and CT scan. Bone scan and chest CT for detection of bony and lung metastasis, (c) Biopsy: either needle or open biopsy, (d) Laboratory investigations.Neo-adjuvant chemotherapy was received in 9 primary cases. Proximal femoral resection and endoprosthetic reconstruction includes three steps: Safe resection of the tumor, reconstruction of the proximal femur with a modular prosthesis and reconstruction of a functional abductor mechanism and soft tissue coverage. The affected limb was then braced in abduction for 6 weeks followed by rehabilitation program. Postoperative adjuvant chemotherapy was received in 9 primary cases and radiotherapy in 6 metastatic patients. All patients underwent clinical and radiographic examination on routine follow-up.In the current study, a total of 18 patients, with average age 40 years, had an average FU period for 48 months. Male to female ratio was 1:0.8. Nine patients had primary lesions, 7 had metastatic disease and 2 had benign lesions. Mean operative time was 143 minutes and mean blood loss was 931 CC. MUTARS implant was used in 6 patients, while Hipokrate implant was used in12 patients. Eleven patients had cementless fixation versus 7 patients with cemented fixation. BHA was the first choice in 14 patients in comparison to 4 patients with THA.In the current study, conserved abduction force was 67% and median range LLD was 0 cm. The mean MSTS and TESS scores were 66, 81 respectively. Recorded complications were: type 1(instability) in 2 patients (11%), no type 2 (aseptic loosening), type 3 (structural failure) in 3 patients (17%), type 4 (infection) in single patient (5.6%), and type 5 (tumor recurrence) in single patient (5.6%). The estimated 2 and 5-year survival rates for treated patients were 81% and 66% respectively. The estimated limb survival rates and implant survival rate at the end of the study were both 94.4%.Limb salvage surgery using endoprosthetic replacement of the proximal femur is a good option for management of proximal femoral tumors with promising functional results.