中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2009年
7期
653-657
,共5页
钛%骨囊肿%骨螺丝%骨髓移植%儿童
鈦%骨囊腫%骨螺絲%骨髓移植%兒童
태%골낭종%골라사%골수이식%인동
Titanium%Bone cysts%Bone Screws%Bone marrow transplantation%Child
目的 探讨AO钛制弹性髓内钉结合自体骨髓囊腔注射治疗儿童长骨单纯性骨囊肿的疗效及特点.方法 肱骨、股骨单纯性骨囊肿患儿18例,男11例,女7例;年龄6～12岁,平均8.1岁;肱骨近端12例,股骨近端5例,股骨中段1例;按Neer等标准,活动期12例,静止期6例.使用AO钛制弹性髓内钉结合自体骨髓囊腔注射进行治疗.测量治疗后3、6、12、18个月的X线片示囊肿残留静止透光区面积并进行统计学分析,评估骨囊肿的愈合情况.结果 18例患儿均获得随访,随访时间11～23个月,平均16个月.骨囊肿愈合时间3～6个月,平均4.8个月.囊肿愈合6例(33.3%),缺损愈合12例(66.7%),愈合率100%.3、6、12、18个月X线片示囊肿残留静止透光区面积逐渐减小,各时间点比较差异有统计学意义.术后除1例患儿因钉尾刺激引起轻度皮肤激惹症状外,余均未发现其他并发症及病理性骨折.结论 AO钛制弹性髓内钉结合自体骨髓囊腔注射治疗儿童骨囊肿不仅囊肿愈合快,愈合率高,而且病灶骨能即刻获得力学稳定,同时可有效预防病理性骨折的发生.
目的 探討AO鈦製彈性髓內釘結閤自體骨髓囊腔註射治療兒童長骨單純性骨囊腫的療效及特點.方法 肱骨、股骨單純性骨囊腫患兒18例,男11例,女7例;年齡6～12歲,平均8.1歲;肱骨近耑12例,股骨近耑5例,股骨中段1例;按Neer等標準,活動期12例,靜止期6例.使用AO鈦製彈性髓內釘結閤自體骨髓囊腔註射進行治療.測量治療後3、6、12、18箇月的X線片示囊腫殘留靜止透光區麵積併進行統計學分析,評估骨囊腫的愈閤情況.結果 18例患兒均穫得隨訪,隨訪時間11～23箇月,平均16箇月.骨囊腫愈閤時間3～6箇月,平均4.8箇月.囊腫愈閤6例(33.3%),缺損愈閤12例(66.7%),愈閤率100%.3、6、12、18箇月X線片示囊腫殘留靜止透光區麵積逐漸減小,各時間點比較差異有統計學意義.術後除1例患兒因釘尾刺激引起輕度皮膚激惹癥狀外,餘均未髮現其他併髮癥及病理性骨摺.結論 AO鈦製彈性髓內釘結閤自體骨髓囊腔註射治療兒童骨囊腫不僅囊腫愈閤快,愈閤率高,而且病竈骨能即刻穫得力學穩定,同時可有效預防病理性骨摺的髮生.
목적 탐토AO태제탄성수내정결합자체골수낭강주사치료인동장골단순성골낭종적료효급특점.방법 굉골、고골단순성골낭종환인18례,남11례,녀7례;년령6～12세,평균8.1세;굉골근단12례,고골근단5례,고골중단1례;안Neer등표준,활동기12례,정지기6례.사용AO태제탄성수내정결합자체골수낭강주사진행치료.측량치료후3、6、12、18개월적X선편시낭종잔류정지투광구면적병진행통계학분석,평고골낭종적유합정황.결과 18례환인균획득수방,수방시간11～23개월,평균16개월.골낭종유합시간3～6개월,평균4.8개월.낭종유합6례(33.3%),결손유합12례(66.7%),유합솔100%.3、6、12、18개월X선편시낭종잔류정지투광구면적축점감소,각시간점비교차이유통계학의의.술후제1례환인인정미자격인기경도피부격야증상외,여균미발현기타병발증급병이성골절.결론 AO태제탄성수내정결합자체골수낭강주사치료인동골낭종불부낭종유합쾌,유합솔고,이차병조골능즉각획득역학은정,동시가유효예방병이성골절적발생.
Objective To study the effects and advantages of the treatment for simple bone cysts of the long bones in children with AO titanium elastic nail and autologous bone marrow injection. Methods Eighteen patients with a simple bone cyst at humerus or femur were managed with AO titanium elastic in-tramedullary nail combined with autologous bone marrow injection. There were eleven boys and seven girls in total, with the mean age of 8.1 years, ranged from 6 to 12 years. Twelve cysts was located in the proximal end of humerus, five in the proximal end of femur and one in the middle part of the shaft of femur. Twelve cysts were active and six inactive according to Neer standard. Radiographic evaluation was performed three, six, twelve and eighteen months after operation during the 11 to 23 months follow-up by taking anteroposteri-or and lateral X-ray pictures. Then we measured residual radiolucent areas on X-ray pictures and did statistic research with group comparison. Results Six cysts (33.3%) healed completely, and twelve (66.7%) healed with residual radiolucent areas which were visible on X-ray pictures 3 to 6 months after operation. Residual radiolucent areas on X-ray pictures gradually reduced during the different phases and it has statistical signif-icance by group comparison. There was no recurrence or major complication except for one patient with mild irritation of skin caused by the end of the nail up to now. Conclusion The treatment for simple bone cysts of the long bones in children combined with AO titanium elastic nail and autologous bone marrow injection not only has satisfactory healing rate but also can provide early stability to the long bones, and accelerate the healing of cysts which allows early mobilization and thus obviates the long-term need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture.
