Stanton R P, Abdel-Mota'al M M
duPont Hospital for Children, Wilmington, Delaware 19899, USA.
J Pediatr Orthop. 1998 Mar-Apr;18(2):198-201.
Growth arrest complicating unicameral bone cyst of the proximal humerus is reported in five patients. These patients represented 10% of 51 consecutive patients treated by the senior author at our hospital from 1988 through 1995. The youngest patient at first clinical presentation was aged 6 years, and the oldest was 14 years 9 months. The follow-up ranged from 35 to 69 months (average, 57.2). The youngest patient at final follow-up was 9 years 1 month, and the oldest was 20 years 5 months. Pathologic fracture was the common clinical presentation in all patients. Growth arrest was diagnosed by limb-length discrepancies, as well as radiographic evidence of premature closure of the physis and deformity of the upper humerus. Treatment was either aspiration of the cyst and local injection of corticosteroids or curettage and bone grafting. Growth arrest was documented, both clinically and radiographically, before the surgery in the two cases treated by curettage and grafting. The origin of growth arrest resulting from unicameral bone cyst remains uncertain. Direct iatrogenic damage to the physis was not a likely cause of growth arrest in this series. Growth arrest as a complication of unicameral bone cyst of the proximal humerus is more common than is generally appreciated (10%).
本文报告了5例肱骨近端单房性骨囊肿并发生长停滞的病例。这些患者占1988年至1995年期间我院资深作者连续治疗的51例患者中的10%。首次临床表现时最年轻的患者为6岁,最年长的为14岁9个月。随访时间为35至69个月(平均57.2个月)。最后一次随访时最年轻的患者为9岁1个月,最年长的为20岁5个月。所有患者的常见临床表现均为病理性骨折。生长停滞通过肢体长度差异以及骨骺过早闭合和肱骨上段畸形的影像学证据来诊断。治疗方法为囊肿抽吸并局部注射皮质类固醇或刮除植骨。在接受刮除植骨治疗的2例病例中,术前临床和影像学均记录到生长停滞。单房性骨囊肿导致生长停滞的原因尚不确定。在本系列中,直接医源性损伤骨骺不太可能是生长停滞的原因。肱骨近端单房性骨囊肿并发生长停滞比一般认为的更为常见(10%)。