Zeng Jiayu,Liang Haohao,Du Jun,et al.Diagnosis and surgery of pathological proximal femoral fractures in children[J].Journal of Clinical Pediatric Surgery,2022,21(08):774-779.[doi:10.3760/cma.j.cn101785-202112029-013]
儿童股骨近端病理性骨折诊疗分析
- Title:
- Diagnosis and surgery of pathological proximal femoral fractures in children
- Keywords:
- Femoral Fractures/SU; Bone Cysts/SU; Bone Cysts; Aneurysmal/SU; Treatment Outcome; Retrospective Studies
- 摘要:
- 目的 回顾性分析儿童股骨近端骨良性病变合并病理性骨折的手术治疗效果,探讨儿童股骨近端病理性骨折的治疗策略。方法 收集2011年5月至2018年10月期间贵州医科大学附属医院小儿外科收治的儿童股骨近端骨良性病变合并病理性骨折患儿临床资料,共14例,其中12例有完整随访信息,2例失访。12例获随访患儿中,单房性骨囊肿6例,动脉瘤样骨囊肿3例,骨纤维结构不良2例,朗格汉斯细胞增生症1例;病变位于左侧5例,右侧7例;男性6例,女性6例;年龄5~14岁,平均年龄8.9岁。术前均经X线(必要时行CT、MRI)及相关辅助检查明确手术范围及内固定方式,采用病灶刮除并植骨联合内固定术。结果 获随访的12例患儿术后随访时间(63.8±5.4)个月(48~78个月),其中1例复发,复发率8.3%;Harris髋关节功能评分为(92.3±7.5)分,评定为优10例,良2例,无一例为差或可,优良率为100%。末次随访时骨与软组织肿瘤协会(Musculoskeletal Tumor Society,MSTS)评分标准评定为(27.17±1.75)分,高于术前的(13.08±1.56)分,差异有统计学意义(P<0.05);无一例出现髋内翻、双下肢不等长、股骨头缺血性坏死或内固定失败等。结论 对于股骨近端良性骨病合并病理性骨折,病灶刮除并植骨联合内固定术可清除病灶、促进骨质生长、恢复股骨近端力学传导,改善患儿患肢功能,提高生活质量。
- Abstract:
- Objective To retrospectively review the surgical outcomes of 12 children of benign lesions of proximal femur with pathological fractures.Methods From May 2011 to October 2018,14 children of benign lesions of proximal femur with pathological fracture were reviewed.There were 6 boys and 6 girls with an average age of 8.9(5-14) years.Twelve cases were followed up and 2 cases became lost.All 12 cases were confirmed by postoperative pathology.The diagnoses included unilocular bone cyst (n=6),aneurysmal bone cyst (n=3),fibrous dysplasia (n=2) and Langerhans cell hyperplasia (n=1).The lesions were located in left proximal femur (n=5) and right proximal femur (n=7).Preoperative imaging examinations of computed tomography (CT) and magnetic resonance imaging (MRI) and related auxiliary examinations were performed.Surgical scopes and approaches were customized.Results The average follow-up period was (63.8±5.4)(48-78) months.One case recurred with a recurrence rate of 8.3%.Harris hip function score averaged (92.3±7.5) points.The outcome was excellent (n=10,83.3%),decent (n=2,16.7%),fair (n=0) and poor (n=0).The overall excellent/decent rate was 100%.The Musculoskeletal Tumor Society (MSTS) score of the last follow-up was higher than that of pre-operation[(27.17±1.75)vs.(13.08±1.56)].There was significant inter-group difference (P<0.05).Conclusion For children with benign osteopathy and pathological fracture of proximal femur,curettage and bone grafting plus internal fixation may remove lesion,promote bone growth,restore mechanical conduction of proximal femur and significantly improve extremity function and quality-of-life.
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相似文献/References:
[1]王强,宋宝健.髋人字支具固定治疗婴幼儿股骨骨折23例[J].临床小儿外科杂志,2008,7(05):1.
备注/Memo
收稿日期:2021-12-27。
通讯作者:姜华,Email:ykxu666@163.com