Tong Zhichao, Zhang Wentao, Jiao Ning, Wang Kunzheng, Chen Bo, Yang Tuanmin
Department of Osteopathy, Xi'an Red Cross Hospital, Xi'an, Shaanxi 710054;
Exp Ther Med. 2013 May;5(5):1355-1358. doi: 10.3892/etm.2013.987. Epub 2013 Mar 4.
The aim of this study was to summarize oncological and functional results and to investigate surgical treatment methods and efficacies by conducting a retrospective study of patients with fibrous dysplasia (FD) in the proximal femur. A total of 15 patients with FD in the proximal femur were selected. Among them, 12 cases were monostotic and 3 cases were polyostotic. In addition, 2 cases were accompanied by shepherd's crook deformity. All cases received internal fixation following focus curettage and impaction grafting. Among them, valgus osteotomy was conducted for 2 cases of shepherd's crook deformity. All patients were followed up for 12-32 months. For 2 patients with shepherd's crook deformity in the proximal femur, the collodiaphysial angle was recovered after an orthopedic procedure following osteotomy. In addition, no patient presented with postoperative recurrent lesions. At 3 months following surgery, local bone resorption was visible in the bone grafting area. Between 8 and 12 months after surgery, the bones in the bone grafting area had healed, pain had disappeared and gaits were nearly normal. An effective internal fixation following thorough focus curettage and allograft bone transplantation is an effective method of treating FD in the proximal femur. For patients with shepherd's crook deformity, it is also necessary to perform valgus osteotomy to recover hip joint function.
本研究的目的是通过对股骨近端纤维发育不良(FD)患者进行回顾性研究,总结肿瘤学和功能结果,并调查手术治疗方法及疗效。共选取了15例股骨近端FD患者。其中,单骨型12例,多骨型3例。此外,2例伴有牧羊拐畸形。所有病例均在病灶刮除及打压植骨后进行内固定。其中,2例牧羊拐畸形患者行外翻截骨术。所有患者均随访12 - 32个月。对于2例股骨近端牧羊拐畸形患者,截骨矫形术后颈干角恢复。此外,无患者出现术后病变复发。术后3个月,植骨区可见局部骨吸收。术后8至12个月,植骨区骨愈合,疼痛消失,步态基本正常。彻底病灶刮除及同种异体骨移植后进行有效的内固定是治疗股骨近端FD的有效方法。对于伴有牧羊拐畸形的患者,进行外翻截骨术以恢复髋关节功能也很有必要。