Mabit C, Huc H, Setton D, Leboutet M J, Arnaud J P, Pecout C
Service d'Orthopédie-Traumatologie I, CHRU Dupuytren, Limoges.
Rev Chir Orthop Reparatrice Appar Mot. 1993;79(1):62-5.
The authors report a case of malignant degeneration arising from a fistula in a patient with chronic osteomyelitis of the femur. This rare complication (0.2 per cent-1.6 per cent) most frequently involves the lower limb. A review of the literature reveals that it is associated with long-standing osteomyelitis (30 years), is most frequently a squamous cell carcinoma or rarely a sarcoma, and is principally treated by surgical amputation. The frequency of metastatic spread is low (30 per cent). Malignant degeneration appears to be a local phenomenon, and if diagnosed early, has a rather favorable outcome following complete excision.
作者报告了一例股骨慢性骨髓炎患者瘘管发生恶性变的病例。这种罕见的并发症(0.2%-1.6%)最常累及下肢。文献回顾显示,它与长期骨髓炎(30年)相关,最常见的是鳞状细胞癌,很少是肉瘤,主要通过手术截肢治疗。转移扩散的发生率较低(30%)。恶性变似乎是一种局部现象,如果早期诊断,在完全切除后有相当好的预后。