Onuba O
University of Calabar Teaching Hospital, Cross River State, Nigeria.
Int Orthop. 1993 Dec;17(6):397-9. doi: 10.1007/BF00180461.
Sickle cell disease involves many organs but musculo-skeletal problems present most often with bone pain, the most common reason for admission to hospital. Two separate pathological abnormalities cause these lesions. Sickling of the red cells produces thromboembolic infarcts in bone leading to pain, crises and sometimes osteomyelitis; increased destruction of sickle red cells produces haemolysis, an increase in erythroblastic activity and expansion of the bone marrow cavity. Dactylitis, avascular necrosis of the head of the femur particularly, osteomyelitis, retardation of growth and leg ulcers are commonly encountered Management is by standard orthopaedic principals. At operation care must be taken in the use of a tourniquet, adequate oxygenation is required and the possibility of acute renal failure must be recognised.
镰状细胞病累及多个器官，但肌肉骨骼问题最常表现为骨痛，这也是住院最常见的原因。两种不同的病理异常导致了这些病变。红细胞镰变在骨骼中产生血栓栓塞性梗死，导致疼痛、危象，有时还会引发骨髓炎；镰状红细胞的过度破坏会导致溶血、成红细胞活性增加以及骨髓腔扩大。常见的有手指炎、尤其是股骨头缺血性坏死、骨髓炎、生长发育迟缓以及腿部溃疡。治疗遵循标准的骨科原则。手术时必须注意使用止血带，需要充分给氧，并且必须认识到急性肾衰竭的可能性。
