中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2010年
10期
941-945
,共5页
李伟栩%严世贵%叶招明%陶惠民%林秾%杨迪生
李偉栩%嚴世貴%葉招明%陶惠民%林秾%楊迪生
리위허%엄세귀%협초명%도혜민%림농%양적생
髋臼%骨囊肿%治疗结果
髖臼%骨囊腫%治療結果
관구%골낭종%치료결과
Acetabulum%Bone cysts%Treatment outcome
目的 探讨髋臼邻关节骨囊肿的诊断、鉴别诊断与治疗方法.方法 回顾性分析1990年8月至2009年4月收治的19例髋臼邻关节骨囊肿患者的I临床资料,男11例,女8例;年龄18~59岁,平均42.3岁.17例有髋关节酸痛不适症状,病程2个月至20年,中位时间为15个月.X线片均显示髋臼负重区近侧椭圆形或圆形溶骨性病变,紧贴软骨下骨,边界清晰,伴有硬化边缘.5例合并髋关节发育不良.刮除病变后予以髂骨植骨14例、异体松质骨颗粒植骨3例、人工骨植骨2例.结果 术前18例确诊,14例依据X线片确诊,4例依据CT和MRI确诊.另1例诊断为单纯性骨囊肿.病灶长径2~4cm者16例,4~8 cm者3例,病灶大小与是否有症状及病程长短无关.17例病灶位于髋臼负重面前上方,2例位于髋臼后上方.全部病例随访11个月至13年,平均6.2年,无囊肿复发.14例无症状,3例偶有髋部不适,2例髋关节发育不良者症状先改善后加重,出现关节间隙狭窄.结论 刮除植骨治疗髋臼邻关节骨囊肿有效,其影像学上病灶分布特点表明病灶发生与应力集中有关.
目的 探討髖臼鄰關節骨囊腫的診斷、鑒彆診斷與治療方法.方法 迴顧性分析1990年8月至2009年4月收治的19例髖臼鄰關節骨囊腫患者的I臨床資料,男11例,女8例;年齡18~59歲,平均42.3歲.17例有髖關節痠痛不適癥狀,病程2箇月至20年,中位時間為15箇月.X線片均顯示髖臼負重區近側橢圓形或圓形溶骨性病變,緊貼軟骨下骨,邊界清晰,伴有硬化邊緣.5例閤併髖關節髮育不良.颳除病變後予以髂骨植骨14例、異體鬆質骨顆粒植骨3例、人工骨植骨2例.結果 術前18例確診,14例依據X線片確診,4例依據CT和MRI確診.另1例診斷為單純性骨囊腫.病竈長徑2~4cm者16例,4~8 cm者3例,病竈大小與是否有癥狀及病程長短無關.17例病竈位于髖臼負重麵前上方,2例位于髖臼後上方.全部病例隨訪11箇月至13年,平均6.2年,無囊腫複髮.14例無癥狀,3例偶有髖部不適,2例髖關節髮育不良者癥狀先改善後加重,齣現關節間隙狹窄.結論 颳除植骨治療髖臼鄰關節骨囊腫有效,其影像學上病竈分佈特點錶明病竈髮生與應力集中有關.
목적 탐토관구린관절골낭종적진단、감별진단여치료방법.방법 회고성분석1990년8월지2009년4월수치적19례관구린관절골낭종환자적I림상자료,남11례,녀8례;년령18~59세,평균42.3세.17례유관관절산통불괄증상,병정2개월지20년,중위시간위15개월.X선편균현시관구부중구근측타원형혹원형용골성병변,긴첩연골하골,변계청석,반유경화변연.5례합병관관절발육불량.괄제병변후여이가골식골14례、이체송질골과립식골3례、인공골식골2례.결과 술전18례학진,14례의거X선편학진,4례의거CT화MRI학진.령1례진단위단순성골낭종.병조장경2~4cm자16례,4~8 cm자3례,병조대소여시부유증상급병정장단무관.17례병조위우관구부중면전상방,2례위우관구후상방.전부병례수방11개월지13년,평균6.2년,무낭종복발.14례무증상,3례우유관부불괄,2례관관절발육불량자증상선개선후가중,출현관절간극협착.결론 괄제식골치료관구린관절골낭종유효,기영상학상병조분포특점표명병조발생여응력집중유관.
Objective To discuss the diagnosis, differential diagnosis and therapeutics of the juxtaarticular bone cyst in the acetabulum. Methods Between August 1990 to April 2009, nineteen cases of clinical data of the juxta-articular bone cyst in the acetabulum data were collected from hospital records and analyzed retrospectively. There were 11 males and 8 females, with an average age of 42.3 years (range, 18-59). Seventeen patients felt an aching pain in the hip. The duration of symptoms was from 2 months to 20years with the median 15 months. All the radiographs showed a well-demarcated oval or circular radiolucent defect, close to subchondral bone, and outlined by a thin rim of sclerotic bone. Five cases accompanied with developmental dysplasia of the hip. After curettage of the bone cyst, 14 patients received iliac crest autogenous bone grafts, 3 patients received xenoma spongy bone-graft particles, and 2 patients received artificial bone grafts. Results Fourteen patients were precisely diagnosed as bone cyst by radiograph, and 4 patients were diagnosed by CT and MRI. The major axes of the focus were 2-4 cm in 16 patients, and 4-8 cm in 3patients. The sizes of the focus had no relationship with the symptoms and the course of the disease. Seventeen cases of the focus were located at the anterior superior of the bearing surface of the acetabulum. All patients were successfully followed up from 11 months to 13 years, averaged 6.2 years, and no relapses occurred during the follow-up period in every case. Fourteen patients felt asymptomatic, 3 patients felt uncomfortable in hip occasionally, and 2 patients with developmental dysplasia of the hip felt ameliorated in the initial stage of the therapy, followed by aggravation accompanying the hip joint space narrow. Conclusion Bone graft after thorough curettage of the capsular space was an effective therapy for the juxta-articular bone cyst in the acetabulum, and the anatomic distribution of radiological lesions indicated that the stress concentration maybe the etiological factor of the bone cyst.