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儿童舟状骨病理性骨折的保守治疗:一例报告。

Conservative treatment of a pathologic fracture of the scaphoid bone in a child: A case report.

作者信息

Solla Federico, Bougamha Walid, Doria Carlo, Musoff Charles, Bertoncelli Carlo M, Rosello Olivier, Rampal Virginie

机构信息

Pediatric Orthopaedic Surgery, Lenval University Children's Hospital Medical school, University of Nice, Nice, France Orthopaedic Surgery, University of Sassari, Italy Yale University, New Haven, CT.

出版信息

Medicine (Baltimore). 2018 Sep;97(36):e12161. doi: 10.1097/MD.0000000000012161.

Abstract

RATIONALE

Tumors of the scaphoid are rare, and some can cause pathological fractures. No cases of pathological fractures of the scaphoid have been reported in children. The most common treatment for pathologic fractures of the scaphoid bone associated with a benign lesion in adults is surgical, with intralesional curettage associated with autologous bone grafting and internal fixation.

PATIENT CONCERNS

A 10-year-old boy presented with wrist pain after falling from his height.

DIAGNOSES

X-ray, CT-scan and MRI showed a pathological undisplaced fracture of the scaphoid on a benign lytic lesion.

INTERVENTIONS

The arm was immobilized in a below-elbow cast.

OUTCOMES

The fracture healed within 4 months of immobilization. 3 years after the fracture, the functional status was normal, and the lytic lesion could not be seen on radiographs.

LESSONS

Retrospectively, the most probable etiology was a ganglion cyst. Our case suggests that some pathological fractures of the scaphoid may not need surgery, especially not in children.

摘要

理论依据

舟骨肿瘤罕见,部分可导致病理性骨折。儿童舟骨病理性骨折尚无病例报道。成人舟骨良性病变相关病理性骨折最常见的治疗方法是手术,即病灶内刮除术联合自体骨移植及内固定。

患者情况

一名10岁男孩从高处坠落致腕部疼痛。

诊断

X线、CT扫描及磁共振成像显示舟骨良性溶骨性病变处病理性无移位骨折。

干预措施

将手臂用肘下石膏固定。

结果

固定4个月内骨折愈合。骨折3年后,功能状态正常,X线片未见溶骨性病变。

经验教训

回顾来看,最可能的病因是腱鞘囊肿。我们的病例提示,部分舟骨病理性骨折可能无需手术,尤其是儿童。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c759/6133437/541a5bc18086/medi-97-e12161-g001.jpg

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