Sakamoto Akio, Arai Ryuzo, Okamoto Takeshi, Matsuda Shuichi
Akio Sakamoto, Ryuzo Arai, Takeshi Okamoto, Shuichi Matsuda, Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto City 606-8507, Japan.
World J Orthop. 2017 Jul 18;8(7):561-566. doi: 10.5312/wjo.v8.i7.561.
To investigate non-ossifying fibromas (NOFs) common fibrous bone lesions in children that occur in bones of the lower extremities.
We analyzed 44 cases of NOF including 47 lesions, which were referred with a working diagnosis of neoplastic lesions. Lesions were located in the upper extremities (1 proximal humerus, 1 distal radius) and the lower extremities (25 distal femurs, 12 proximal and 4 distal tibias, and 4 proximal fibulas).
Three cases had NOFs in multiple anatomical locations (femur and fibula in 1 case, femur and tibia in 2 cases). Overall, larger lesions > 4 cm and lesion expansion at the cortex were seen in 21% and 32% of cases, respectively. Multiple lesions with bilateral symmetry in the lower extremities suggest that these NOFs were developmental bone defects. Two patients suffered from fracture and were treated without surgery, one in the radius and one in the femur. Lesions in the upper extremities (., humerus of a 4-year-old female and radius of a 9-year-old male) expanded at the cortex and lesion size increased with slow ossification.
NOFs in the lower extremity had fewer clinical problems, regardless of their size and expansiveness. In these two upper extremity cases, the NOFs had aggressive biological features. It seems that there is a site specific difference, especially between the upper extremity and the lower extremity. Furthermore, NOFs in the radius are predisposed to fracture because of the slender structure of the radius and the susceptibility to stress.
研究非骨化性纤维瘤（NOF），这是一种常见于儿童下肢骨骼的纤维性骨病变。
我们分析了44例NOF，包括47个病变，这些病例最初被诊断为肿瘤性病变。病变位于上肢（1例近端肱骨、1例远端桡骨）和下肢（25例远端股骨、12例近端胫骨和4例远端胫骨，以及4例近端腓骨）。
3例在多个解剖部位存在NOF（1例为股骨和腓骨，2例为股骨和胫骨）。总体而言，分别有21%的病例出现大于4 cm的较大病变，32%的病例出现皮质处病变扩展。下肢多个病变呈双侧对称，提示这些NOF为发育性骨缺损。2例患者发生骨折，均未接受手术治疗，1例发生在桡骨，1例发生在股骨。上肢病变（如1例4岁女性的肱骨和1例9岁男性的桡骨）在皮质处扩展，病变大小随骨化缓慢增加。
下肢的NOF临床问题较少，无论其大小和扩展性如何。在这2例上肢病例中，NOF具有侵袭性生物学特征。似乎存在部位特异性差异，尤其是在上肢和下肢之间。此外，由于桡骨结构细长且易受应力影响，桡骨的NOF易发生骨折。
