From the Facultad de Medicina Universidad Peruana Cayetano Heredia, Lima, Peru (Dr. González, Dr. Bryce-Alberti); the Department of Radiology, Division of Musculoskeletal Radiology, University of Miami Miller School of Medicine (Dr. Subhawong); the Department of Bone and Soft Tissue Pathology, Miami Miller School of Medicine (Dr. Hakim, Dr. Rosenberg); and the Department of Orthopaedics, Division of Musculoskeletal Oncology, University of Miami Miller School of Medicine, Miami, FL (Dr. Pretell-Mazzini).
J Am Acad Orthop Surg Glob Res Rev. 2021 Jun 2;5(6):e21.00055-7. doi: 10.5435/JAAOSGlobal-D-21-00055.
An 18-year-old man presented with a pathological fracture of the right proximal femur. Desmoplastic fibroma was diagnosed through histological studies. Surgical management involved extended intralesional curettage and fracture stabilization by open reduction with intramedullary nailing, using a short Gamma nail. At 42-month follow-up, the patient presented no limitations or recurrence. Internal fixation after prior intralesional curettage is a valid treatment strategy for pathological fractures in young patients. A short nail was chosen to prevent direct tumor cell seeding throughout the femur and future recurrence. Fracture consolidation was achieved because of the healing potential of a young patient.
一位 18 岁男性因右侧股骨近端病理性骨折就诊。通过组织学研究诊断为促纤维增生性纤维瘤。手术治疗采用广泛的病灶内刮除术,并通过切开复位髓内钉固定(使用短 Gamma 钉)进行骨折稳定。42 个月随访时,患者无任何限制或复发。对于年轻患者的病理性骨折,病灶内刮除术后的内固定是一种有效的治疗策略。选择短钉可防止肿瘤细胞直接种植于整个股骨并预防未来复发。由于年轻患者的愈合潜力,骨折得以愈合。