Keijser L C, Van Tienen T G, Schreuder H W, Lemmens J A, Pruszczynski M, Veth R P
Department of Orthopaedics, University Medical Center St. Radboud, Nijmegen, The Netherlands.
J Surg Oncol. 2001 Mar;76(3):157-66; discussion 167-8. doi: 10.1002/jso.1028.
Fibrous dysplasia of bone is difficult to manage because of its variable clinical course with many different methods of treatment reported. Therefore we report on our experience.
We reviewed a series of 20 patients with 32 lesions included. The average age at the time of diagnosis was 32 years for monostotic disease, 26 years for polyostotic disease, and 3 years for McCune-Albright syndrome. The median follow-up period was 6 years. Functional and radiographic outcomes were scored.
Monostotic disease mostly presented with a circumscribed lesion and monitoring was often sufficient. Symptomatic circumscribed lesions showed satisfactory outcome when treated with curettage, cryosurgery and bone grafting. Lesions of the extended type were most of all seen in polyostotic disease and eventually needed operative treatment. In case of bony deformity, corrective osteotomies and rigid internal fixation were performed in addition to curettage, cryosurgery, and bone grafting. In polyostotic disease, expected outcomes were good, but in McCune-Albright syndrome, results were uniformly poor. J. Surg. Oncol. 2001;76:157-166.
骨纤维异常增殖症因其临床病程多变且有多种不同的治疗方法报道,故治疗颇具难度。因此,我们报告我们的经验。
我们回顾了一系列20例患者,共纳入32处病损。单骨型疾病诊断时的平均年龄为32岁,多骨型疾病为26岁,McCune-Albright综合征为3岁。中位随访期为6年。对功能和影像学结果进行评分。
单骨型疾病大多表现为局限性病损,通常监测即可。有症状的局限性病损经刮除、冷冻手术及骨移植治疗后效果满意。扩展型病损多见于多骨型疾病,最终需要手术治疗。对于骨畸形,除刮除、冷冻手术及骨移植外,还需行截骨矫形及坚强内固定。多骨型疾病的预期效果良好,但McCune-Albright综合征的结果均较差。《外科肿瘤学杂志》2001年;76卷:157 - 166页。