Tomaszewski Ryszard, Pethe Karol, Kler Jacek
Oddział Urazowo-Ortopedyczny, Górnoślaskie Centrum Zdrowia Dziecka im. Jana Pawła II w Katowicach.
Chir Narzadow Ruchu Ortop Pol. 2011 May-Jun;76(3):151-3.
Disclosure of the tumor area intertrochanteric femur occurs mostly at the time of pathological fracture. Detection of changes can also be made in conjunction with x-ray of the hip joint such as the hip injury. The purpose of this study was to present the treatment of benign tumors of the intertrochanteric area in children and adolescents.
From 1. 01. 2002 to 31. 12. 2009 13 patients were treated with benign tumors of the femur intertrochanteric area, including 10 with pathological fractures in the background. Average age was 9.8 years (5-13 years). There were 11 boys and 2 girls. The procedure was performed with resection of the tumor,histopathology, allogenic bone grafting, the femur was fixed using locked plate (10 patients) or angular plate (3 patients).
The mean observation time was 62 months (24-94 months). Histopathology examination showed a simple cyst in 7 patients, aneurysmal cyst in 2 patients, and fibrous dysplasia of bone in 4 patients. Bone consolidation was achieved in 10 patients after an average of 4 months (3-5 months) after surgery, as determined by X-ray examination and clinical examination. In 3 cases there was a recurrence of the tumor, 2 patients with fibrous dysplasia after 4 months and 6 months after surgery were found in X-ray partial resorption of bone graft >25%, and 1 patient after 4 months presented fatigue fracture at Adams angle. After re-treatment complete bone consolidation was achieved in this group after an average of 4 months (2.5-5 months) from the second surgery. 1 patient with aneurysmal cyst in 11 month after surgery, presented femoral infection, sequestrum and plate were surgically removed, antibiotic therapy was used and the inflammatory process was stopped.
Surgical treatment of benign tumors of the intertrochanteric area of the femur gives good results if it is carried out by a complex surgery (resection of the tumor - bone graft - osteosynthesis).
股骨转子间区域肿瘤多在病理性骨折时被发现。髋关节X线检查如髋关节损伤时也可发现病变。本研究旨在介绍儿童和青少年股骨转子间区域良性肿瘤的治疗方法。
2002年1月1日至2009年12月31日,13例股骨转子间区域良性肿瘤患者接受治疗,其中10例伴有病理性骨折。平均年龄9.8岁(5 - 13岁)。男11例,女2例。手术包括肿瘤切除、组织病理学检查、同种异体骨移植,10例患者使用锁定钢板固定股骨,3例使用角钢板固定。
平均观察时间62个月(24 - 94个月)。组织病理学检查显示,7例为单纯囊肿,2例为动脉瘤样骨囊肿,4例为骨纤维异常增殖症。术后平均4个月(3 - 5个月),10例患者经X线检查和临床检查确定达到骨愈合。3例肿瘤复发,2例骨纤维异常增殖症患者术后4个月和6个月X线显示骨移植部分吸收>25%,1例患者术后4个月在亚当斯角处出现疲劳骨折。再次治疗后,该组患者自第二次手术起平均4个月(2.5 - 5个月)实现完全骨愈合。1例动脉瘤样骨囊肿患者术后11个月出现股骨感染,手术取出死骨和钢板,使用抗生素治疗,炎症得到控制。
股骨转子间区域良性肿瘤采用复杂手术(肿瘤切除 - 骨移植 - 骨固定)治疗效果良好。