| 股骨近端纤维结构不良的手术治疗 |
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投稿时间：2010-08-19
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| 作者 | Author | 单位 | Address | E-Mail |
| 同志超 |
TONG Zhi-chao |
西安市红十字会医院骨病科, 陕西 西安 710054 |
Department of Osteopathia, Xi'an Red Cross Hospital, Xi'an 710054, Shaanxi, China |
zhichaotong@126.com |
| 王坤正 |
WANG Kun-zheng |
西安交通大学第二医院骨科 |
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| 焦宁 |
JIAO Ning |
西安市红十字会医院骨病科, 陕西 西安 710054 |
Department of Osteopathia, Xi'an Red Cross Hospital, Xi'an 710054, Shaanxi, China |
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| 杨团民 |
YANG Tuan-min |
西安市红十字会医院骨病科, 陕西 西安 710054 |
Department of Osteopathia, Xi'an Red Cross Hospital, Xi'an 710054, Shaanxi, China |
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| 张文 |
ZHANG Wen |
西安市红十字会医院骨病科, 陕西 西安 710054 |
Department of Osteopathia, Xi'an Red Cross Hospital, Xi'an 710054, Shaanxi, China |
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| 陈博 |
CHEN Bo |
西安市红十字会医院骨病科, 陕西 西安 710054 |
Department of Osteopathia, Xi'an Red Cross Hospital, Xi'an 710054, Shaanxi, China |
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| 期刊信息：《中国骨伤》2011年，第24卷，第4期，第345-348页 |
| DOI：10.3969/j.issn.1003-0034.2011.04.023 |
| 基金项目: |
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中文摘要:
目的：通过对股骨近端纤维结构不良病例进行回顾性研究, 总结肿瘤学和功能学结果, 探讨其治疗方法及效果。
方法：2007年4月至2009年1月, 收治15例股骨近端纤维结构不良患者, 男9例, 女6例；年龄16～32岁, 平均25岁；单侧病变12例, 双侧病变3例；单骨型12例, 多骨型3例；病程2个月～16年, 平均2年。股骨近端纤维结构不良伴髋内翻2例, 颈干角分别为80°和100°, 股骨长度较对侧短缩分别为5 cm和3 cm.所有患者采用病灶刮除、打压植骨(同种异体人工骨和/或自体髂骨)、内固定治疗, 其中2例牧羊拐畸形者采用外翻截骨矫形术。
结果：所有患者获随访, 时间12～32个月, 2例股骨近端牧羊拐畸形患者经截骨矫形后畸形矫正, 颈干角恢复, 股骨长度延长分别为4 cm和3 cm, 术后4个月扶双拐下地行走。所有患者术后病变无复发及内固定物松动, 植骨区术后3个月可见局部骨吸收, 术后8～12个月植骨区骨愈合, 疼痛消失, 步态正常。
结论：彻底刮除病灶、植骨及有效内固定是治疗股骨近端纤维结构不良的有效方法, 对伴有牧羊拐畸形者应同时行外翻截骨以恢复髋关节功能。 |
| 【关键词】股骨 骨移植 刮除术 截骨术 |
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| Surgical treatment of fibrous dysplasia in proximal femur |
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ABSTRACT
Objective: To summarize the oncological and functional results of patients with fibrous dysplasia in the proximal femur and explore its clinical effect.
Methods: From Apr. 2007 to Jan. 2009, 15 patients with fibrous dysplasia in proximal femur were treated. There were 9 males and 6 females, ranging in age from 16 to 32 years with an average of 25 years. The course of disease was from 2 months to 16 years with an average of 2 years. Among them, 12 cases were unilateral affection and 3 cases were hibateral affections;12 cases were one bone and 3 cases more than two bones. The collodiaphyseal angles of 2 cases with coxa adducta was 80°and 100° respectively; and femur lengths were shorter than opposite side (5 cm and 3 cm, respectively). The curettage and allogenous and/or autogenous bone-grafting combined with internal fixation were performed in all patients and valgus osteotomies was performed in 2 case with shepherd's crook deformity.
Results: All patients were followed up from 12 to 32 months. Two cases with shepherd's crook deformity, the collodiaphyseal angles recovered after surgery, the relative length of femur was increased 4 cm and 3 cm respectively and they can walk with stick at 4 months after operation. No found recurrence and loosening of internal fixation. Bone graft was absorbed at 3 months and bone healing at 8-12 months after operation. The pain vanished and functions were normal.
Conclusion: It is an effective method to treat fibrous dysplasia in proximal fumur with curettage and bone-grafting combined with internal fixation. Corrective osteotomy and internal fixation with a dynamic hip screw is a good and effective method in treating severe symptomatic shepherd's crook deformity. |
| KEY WORDS Femur Bone transplantation Curettage Osteotomy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 同志超,王坤正,焦宁,杨团民,张文,陈博.股骨近端纤维结构不良的手术治疗[J].中国骨伤,2011,24(4):345~348 |
| 英文格式: | TONG Zhi-chao,WANG Kun-zheng,JIAO Ning,YANG Tuan-min,ZHANG Wen,CHEN Bo.Surgical treatment of fibrous dysplasia in proximal femur[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(4):345~348 |
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