Norman-Taylor Fabian H, Hashemi-Nejad Aresh, Gillingham Bruce L, Stevens David, Cole William G
Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Orthop. 2002 Mar-Apr;22(2):249-54.
The authors determined the results after traction or traction and hip spica treatment of the initial fractures through unicameral bone cysts of the proximal femur in 20 children. All of the eight displaced fractures healed, but with coxa vara and avascular necrosis in one, coxa vara in a second, and coxa breva in a third. Spontaneous healing of the cyst occurred in three of the eight children; satisfactory healing was achieved and maintained after intralesional corticosteroid injections in four of the eight children. In the remaining child with a displaced fracture, reactivation of the cyst and exercise-related pain, indicative of an incipient refracture, occurred 3 years after initial presentation. All of the 12 undisplaced fractures healed without deformity or avascular necrosis. Intralesional corticosteroids were used in all of the 12 children because none of them showed spontaneous healing of their cysts. Satisfactory radiographic healing was achieved 1 year after presentation in all of the 12 children. However, one or more refractures resulting from reactivation of the cyst occurred in 6 of the 12 children 2 to 5 years after initial presentation. The results of this study indicate that satisfactory radiographic healing needs to be achieved by the end of the first year and needs to be maintained thereafter to prevent refractures.
作者们确定了20名患有股骨近端单房性骨囊肿的儿童初始骨折经牵引或牵引加髋人字石膏治疗后的结果。8例移位骨折均愈合，但1例出现髋内翻和缺血性坏死，第2例出现髋内翻，第3例出现髋短缩。8名儿童中有3例囊肿自发愈合；8名儿童中有4例经病灶内注射皮质类固醇后获得并维持了满意的愈合。在其余1例移位骨折的儿童中，初次就诊3年后囊肿复发并出现与运动相关的疼痛，提示早期再骨折。12例无移位骨折均愈合，无畸形或缺血性坏死。12名儿童均使用了病灶内皮质类固醇，因为他们的囊肿均未自发愈合。12名儿童初次就诊1年后均获得了满意的影像学愈合。然而，12名儿童中有6例在初次就诊2至5年后因囊肿复发出现1处或多处再骨折。本研究结果表明，需要在第一年末实现满意的影像学愈合，并在此后维持，以防止再骨折。
