Luo Shanchao, Jiang Tongmeng, Yang Xiaoping, Yang Yingnian, Zhao Jinmin
1 Yulin Orthopedics Hospital of Chinese and Western Medicine, Yulin, China.
2 Postdoctoral Innovation Practice Base, The Ninth Affiliated Hospital of Guangxi Medical University, Beihai, China.
J Int Med Res. 2019 Feb;47(2):823-835. doi: 10.1177/0300060518813510. Epub 2018 Dec 16.
Surgical resection of benign bone tumors and tumor-like lesions at the femoral neck presents a difficult reconstructive challenge. However, the safety and efficacy of free nonvascularized fibular autografts (FNFAs) in the treatment of femoral neck tumor-like lesions before epiphyseal closure in young patients remain unknown.
Sixteen pediatric patients who had not yet undergone epiphyseal closure were treated with FNFAs after resection of tumor-like lesions in the femoral neck from August 2012 to September 2016. All patients underwent supplementary skeletal traction through the supracondylar femur for 4 to 6 weeks after resection. Demographic data were recorded and clinical and radiological outcomes were evaluated during the follow-up.
All patients could walk with partial weight bearing 4 weeks postoperative, and full weight bearing was permitted after a mean of 8 weeks. Graft union was attained in all 16 patients at a mean of 2 months. The donor site of the fibular cortical strut showed good regeneration in all patients. The Harris hip score significantly improved from 65% to 95%.
Application of an FNFA is a feasible method in the treatment of tumor-like lesions in the femoral neck before epiphyseal closure in pediatric patients.
Level IV.
股骨颈良性骨肿瘤及肿瘤样病变的手术切除带来了重建方面的难题。然而，游离非血管化腓骨自体骨（FNFAs）用于治疗年轻患者骨骺闭合前股骨颈肿瘤样病变的安全性和有效性仍不明确。
2012年8月至2016年9月，16例尚未经历骨骺闭合的儿科患者在股骨颈肿瘤样病变切除后接受了FNFAs治疗。所有患者在切除后通过股骨髁上进行4至6周的辅助骨骼牵引。记录人口统计学数据，并在随访期间评估临床和放射学结果。
所有患者术后4周可部分负重行走，平均8周后允许完全负重。16例患者均在平均2个月时实现植骨愈合。所有患者腓骨皮质支柱供区均显示良好再生。Harris髋关节评分从65%显著提高到95%。
对于儿科患者骨骺闭合前股骨颈肿瘤样病变的治疗，应用FNFAs是一种可行的方法。
四级。
