Li Lianyong, Hou Xiangyu, Li Qiwei, Zhang Lijun
Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, P,R, China.
World J Surg Oncol. 2014 Nov 18;12:349. doi: 10.1186/1477-7819-12-349.
The surgical treatment of fibrous dysplasia remains a challenge for the pediatric orthopedist because of its high recurrence rate. Although a few successful treatments have been reported by using en bloc resection and bone graft in adults, this has not been reproduced in children. In this report, the authors present two children (2.5 and 6 years old) with monostotic expansile fibrous dysplasia involving the ulna and fibula, respectively, who underwent en bloc resection and autograft to replace the involved bones. Good bone union and functional recovery were obtained postoperatively. However, during a follow-up period of 8 and 5 years, respectively, the lesions recurred completely, and the deformities remained progressing over time. En bloc resection and bone graft cannot prevent recurrence in skeletally immature patients with monostotic expansile fibrous dysplasia, and cannot alter for the natural history of the disease. A combination of other management should be considered in children with fibrous dysplasia.
由于纤维结构不良的高复发率，其外科治疗对小儿骨科医生来说仍是一项挑战。尽管已有报道称在成人中采用整块切除和骨移植取得了一些成功的治疗案例，但在儿童中尚未得到重现。在本报告中，作者介绍了两名分别为2.5岁和6岁的儿童，他们分别患有累及尺骨和腓骨的单骨型膨胀性纤维结构不良，均接受了整块切除和自体骨移植以替换受累骨骼。术后获得了良好的骨愈合和功能恢复。然而，在分别为期8年和5年的随访期内，病变完全复发，畸形随时间持续进展。对于骨骼未成熟的单骨型膨胀性纤维结构不良患者，整块切除和骨移植无法预防复发，也无法改变疾病的自然病程。对于患有纤维结构不良的儿童，应考虑联合其他治疗方法。
