Service de chirurgie orthopédique et traumatologique, faculté de médecine de Sfax, CHU Habib Bourguiba, route El-Aïn Km 0,5 CP, 3029 Sfax, Tunisie.
Orthop Traumatol Surg Res. 2010 Feb;96(1):85-9. doi: 10.1016/j.rcot.2009.12.005.
Bone hydatid disease is a rare pathology, characterized by its long clinical latency, the absence of radiological specificity as well as its challenging surgical treatment. We report an observation of pelvic bone hydatidosis in a 28-year-old patient, appearing with pain and stiffness of the hip as well as a degenerative aspect on the coxofemoral joint on X-ray. The treatment consisted of an extensive hemipelvectomy with femoro pelvic arthrodesis, completed by medical treatment. The functional result was excellent in spite of a break in the fixation material, which allowed a certain mobility at the proximal end of the femur. Hydatid disease of bone is infiltrating,diffuse, slow, and progressive, all characteristics explaining the often-delayed diagnosis. Medical imaging provides accurate analysis for planning a broad surgical resection. The quality of surgical resection is determined according to the risk of recurrence. Pelvic locations are particularly difficult to treat. After an enlarged and difficult surgical resection, reconstruction remains aleatory and poses many technical problems.
骨包虫病是一种罕见的疾病,其特点是临床潜伏期长、影像学缺乏特异性以及手术治疗具有挑战性。我们报告了一例 28 岁患者的骨盆包虫病,表现为髋关节疼痛和僵硬,以及髋关节 X 线显示退行性改变。治疗方法包括广泛的半骨盆切除术和股骨骨盆融合术,辅以药物治疗。尽管固定材料断裂,导致股骨近端有一定的活动度,但功能结果仍非常出色。骨包虫病具有浸润性、弥散性、缓慢和进行性的特点,所有这些特征都解释了其常常延迟诊断的原因。医学影像学为广泛的手术切除提供了准确的分析。手术切除的质量取决于复发的风险。骨盆部位尤其难以治疗。在进行了广泛而困难的手术切除后,重建仍然具有不确定性,并带来许多技术问题。