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锁定加压 pediatric hip plate™ 在儿童股骨近端肿瘤中的应用。

Application of the Locking Compression Pediatric Hip Plate™ in children with proximal femoral tumors.

机构信息

Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

出版信息

J Orthop Surg Res. 2022 Dec 12;17(1):536. doi: 10.1186/s13018-022-03433-6.

Abstract

BACKGROUND

Pediatric proximal femoral tumors often present with accumulative and severe bone destruction and are often complicated by pathological fractures and malunion. Such tumors are treated clinically by lesion scraping and graft reconstruction with autologous iliac bone alone or in combination with artificial bone. This study aimed to determine the efficacy of the Locking Compression Pediatric Hip Plate™ in treating pediatric proximal femoral tumors.

METHODS

From 2012-2017, the Locking Compression Pediatric Hip Plate™ was applied for internal fixation in 28 children in the Department of Pediatric Surgery. The complications were pathological fractures in 19 patients and multiple lesions in 5 patients. Tumors were removed by tumor curettage and reconstruction with autogenous iliac bone or artificial bone graft. The Locking Compression Pediatric Hip Plate™ was then applied. Postoperative pathological examination confirmed the diagnosis.

RESULTS

The cohort comprised 20 males and 8 females (mean age 7.8 ± 2.9 years). The mean follow-up duration was 26.1 ± 8.1 months (range 18-48 months). Post-treatment radiography showed that the lesions and local pathological fractures were healed in 3.2 ± 0.4 months (range 3-4 months), with no complications. Four patients continued to receive antineoplastic therapy postoperatively. Four patients experienced recurrence in situ, while another four developed distant metastases. The radiographic and joint function findings indicated that the affected limbs had excellent function. The mean Enneking score was 28.7 ± 1.0 points (range 27-30 points).

CONCLUSIONS

Internal fixation with the Locking Compression Pediatric Hip Plate™ in children achieves good therapeutic effects. Moreover, the Locking Compression Pediatric Hip Plate™ resolves the shortcomings of external fixation by traditional plaster casts and internal fixation by Kirschner wires and elastic intramedullary screws.

摘要

背景

小儿股骨近端肿瘤常表现为进行性、严重的骨质破坏,常合并病理性骨折和畸形愈合。此类肿瘤临床多采用病灶刮除、自体髂骨植骨重建,或联合人工骨植骨重建。本研究旨在探讨应用锁定加压儿童髋钢板治疗小儿股骨近端肿瘤的疗效。

方法

2012 年至 2017 年,我院小儿外科应用锁定加压儿童髋钢板治疗 28 例小儿股骨近端肿瘤患者,其中 19 例合并病理骨折,5 例为多发病灶。肿瘤刮除后,取自体髂骨或人工骨植骨重建,再应用锁定加压儿童髋钢板内固定。术后均经病理检查证实诊断。

结果

本组男 20 例,女 8 例;年龄 7.8±2.9 岁。平均随访时间 26.1±8.1 个月(1848 个月)。术后复查 X 线片示,所有患者的病灶及局部病理性骨折均于 3.2±0.4 个月(34 个月)愈合,无并发症发生。术后 4 例继续行抗肿瘤治疗。4 例原位复发,4 例发生远处转移。末次随访时,患肢功能按 Enneking 评分标准评定:优 25 例,良 3 例。

结论

锁定加压儿童髋钢板治疗小儿股骨近端肿瘤疗效确切,避免了传统石膏外固定和克氏针、弹性髓内钉内固定的缺点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05a8/9743614/007b500dcdff/13018_2022_3433_Fig1_HTML.jpg

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