Yamaguchi Sakura, Furuhata Ryogo, Tanji Atsushi, Urabe Tadahisa
Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan.
Trauma Case Rep. 2023 Aug 11;47:100895. doi: 10.1016/j.tcr.2023.100895. eCollection 2023 Oct.
Non-ossifying fibromas are extremely rare in the upper extremity, such as those in the radius and humerus. The treatment of completely displaced fractures following non-ossifying fibromas in the radius has not been reported. We present the case of a pathological fracture caused by a non-ossifying fibroma in the radius treated using external fixation. The patient was a 10-year-old girl who presented to our hospital with right forearm pain after an accidental fall. She had no remarkable medical history. Radiographs and computed tomography showed a pathological fracture through osteolytic lesions with sclerotic rims in the diaphysis of the radius, suggesting a pathological fracture through a non-ossifying fibroma in the radius. We performed tumor curettage and external fixation due to marked fracture displacement. Histological findings were compatible with those of non-ossifying fibroma. Six months post-surgery, there were no limitations in the range of motion of supination and pronation of the forearm, and radiographs confirmed a bone union. Although non-ossifying fibromas in the radius are rare, cases with large lesions can cause pathological fractures after minor trauma. This case suggests that curettage and external fixation are beneficial, especially if early surgery is required due to unacceptable displacement and when there is no time for a biopsy to rule out malignancy.
非骨化性纤维瘤在上肢极为罕见，如发生在桡骨和肱骨的此类肿瘤。桡骨非骨化性纤维瘤后完全移位骨折的治疗尚无报道。我们报告一例桡骨非骨化性纤维瘤所致病理性骨折采用外固定治疗的病例。患者为一名10岁女孩，因意外跌倒后出现右前臂疼痛前来我院就诊。她既往无显著病史。X线片和计算机断层扫描显示桡骨干骺端溶骨性病变伴硬化边缘处有一病理性骨折，提示为桡骨非骨化性纤维瘤所致病理性骨折。由于骨折明显移位，我们进行了肿瘤刮除术和外固定。组织学检查结果与非骨化性纤维瘤相符。术后6个月，前臂旋前和旋后活动范围无受限，X线片证实骨折愈合。尽管桡骨非骨化性纤维瘤罕见，但病变较大的病例在轻微创伤后可导致病理性骨折。该病例表明，刮除术和外固定是有益的，特别是当因不可接受的移位需要早期手术且没有时间进行活检以排除恶性肿瘤时。
