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骨质石化症——骨科医生面临的一项挑战。

Osteopetrosis--a challenge for the orthopaedic surgeon.

作者信息

Cadosch Dieter, Gautschi Oliver P, Brockamp Thomas, Zellweger René

机构信息

Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, School of Anatomy and Human Biology, University of Western Australia, Australia.

出版信息

S Afr J Surg. 2009 Nov;47(4):131-3.

Abstract

Osteopetrosis (OP) is a rare heterogeneous group of inherited skeletal dysplasias characterised by osteoclast dysfunction, impaired bone resorption and poor bone remodelling. Three groups can be categorised on the basis of clinical findings. These include neurological symptoms, haematological abnormalities and renal tubular acidosis in the first group. Increased bone density, osteomyelitis and frequent fractures are the clinical findings in the second group, and the third group have normal life expectancy but may develop cranial nerve compression and osteomyelitis. Fractures in patients with OP are common and require appropriate pre-, peri- and postoperative management. The long bones are most frequently affected, fractures of the femoral neck and proximal (upper third) shaft being particularly common. This case report proposes possible operative fracture treatment in a patient with OP and highlights the potential perioperative pitfalls in this rare surgical population.

摘要

骨硬化症(OP)是一组罕见的遗传性骨骼发育异常的异质性疾病,其特征为破骨细胞功能障碍、骨吸收受损和骨重塑不良。根据临床表现可分为三组。第一组包括神经症状、血液学异常和肾小管酸中毒。第二组的临床表现为骨密度增加、骨髓炎和频繁骨折,第三组预期寿命正常,但可能发生颅神经受压和骨髓炎。OP患者骨折很常见,需要进行适当的术前、术中和术后管理。长骨最常受累,股骨颈和近端(上三分之一)骨干骨折尤为常见。本病例报告提出了OP患者可能的手术骨折治疗方法,并强调了这一罕见手术人群围手术期可能存在的陷阱。

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