Betsy Michael, Kupersmith Lee M, Springfield Dempsey S
Leni and Peter W. May Department of Orthopaedics, The Mount Sinai Medical Center, Box 1188, 9th Floor, 5 East 98th Street, New York, NY 10029, USA.
J Am Acad Orthop Surg. 2004 Mar-Apr;12(2):89-95. doi: 10.5435/00124635-200403000-00004.
Nonossifying fibromas and fibrous cortical defects are the most common benign lesions of the skeletal system. They are frequently detected incidentally on radiographs taken for an unrelated reason. The diagnosis is routinely made solely on the basis of the history, physical examination, and radiographic appearance. The incidence of multifocal nonossifying fibroma is typically underestimated in patients initially found to have a solitary lesion; the use of a limited skeletal survey rather than bone scan may help detect multifocal lesions in this population. Small, asymptomatic lesions may be followed over time using serial radiographs. Incisional biopsy, curettage, and bone grafting are indicated for large lesions that raise concern for impending pathologic fracture, for lesions that have become painful, and for lesions whose characteristics prevent a definitive radiographic diagnosis. Pathologic fractures involving these lesions should be treated with cast immobilization until the fracture has healed, followed by biopsy, curettage, and bone grafting.
非骨化性纤维瘤和纤维皮质缺损是骨骼系统最常见的良性病变。它们常在因无关原因拍摄的X线片上偶然被发现。诊断通常仅基于病史、体格检查和X线表现。最初发现为单发病变的患者中，多灶性非骨化性纤维瘤的发生率通常被低估；使用有限的骨骼检查而非骨扫描可能有助于在该人群中发现多灶性病变。小的无症状病变可通过连续X线片随诊观察。对于引起即将发生病理性骨折担忧的大病变、已出现疼痛的病变以及其特征无法通过X线明确诊断的病变，需进行切开活检、刮除术和植骨。涉及这些病变的病理性骨折应采用石膏固定治疗，直至骨折愈合，随后进行活检、刮除术和植骨。
