Li Haibing,Ye Wensong,Xu Lujie,et al.Treatment strategies for proximal femoral benign bone lesions in children[J].Journal of Clinical Pediatric Surgery,,19():241-247.[doi:10.3969/j.issn.1671-6353.2020.03.010]
Treatment strategies for proximal femoral benign bone lesions in children
- Keywords:
- Femoral Neoplasms/SU; Proximal Femur; Fractures; Spontaneous; Child
- CLC:
- R726.8;R739.96;R683.4
- Abstract:
- Objective To explore the surgical treatment strategies for benign bone lesions of proximal femur in children.Methods Twenty-one children with proximal femoral benign bone lesions were analyzed retrospectively from January 2010 to December 2016.There were 13 boys and 8 girls with a mean age of 7.3 years.The involved side was left (n=10) and right (n=11).Histopathological diagnoses were simple (n=9) or aneurysmal (n=5) bone cysts,nonossifying fibromas (n=3) and fiber dysplasia (n=4).Pathological fracture was concurrent in 12 cases.Surgical strategies were based on patient’s skeletal maturity,localization and initial diagnosis of lesion and amount of bone loss in femoral neck and lateral proximal femur.Surgical procedures consisted of biopsy,curettage,bone grafting and internal fixation when required.Results The average follow-up period was 2.8 (2.0-4.3) years.There were complete healing (n=12),defect healing (n=6),persistent existence (n=2) and recurrence (n=1).The average healing time was 5.7 (4-7) months with a healing rate of 85.7%.Postoperative MTST score showed a statistically significant difference compared with preoperative (t=17.091,P<0.001).The average healing time of pathological fracture was 7.2 (6-8) weeks.There were hip varus deformity (n=1) and wound infection (n=1).Failure of metallic implant,injury to growth plate or avascular necrosis of femoral head were not observed.Conclusion Surgical treatment of benign lesions of proximal femur is based upon localization and initial diagnosis of lesion,amount of bone loss in femoral neck and lateral proximal femur and patient’s skeletal maturity.Effective treatment options for different types of lesions enable local tumor control and yield excellent long-term functional and radiological outcomes.
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Memo
收稿日期:2019-05-30。
基金项目:浙江省科技厅计划项目（编号：2017C33026）
通讯作者:叶文松,Email:6192005@zju.edu.cn