肿瘤刮除植骨并可吸收螺钉固定治疗股骨头软骨母细胞瘤  

Treatment of the femoral head chondroblastoma with curettage, bone grafting and absorbable screw fixation

作　　者：王林[1,2] 吴学建[1] 王顺利[2] 史迎宾[2] 

机构地区：[1]郑州大学第一附属医院创伤骨科,郑州450052 [2]郑州市骨科医院骨肿瘤科

出　　处：《中国矫形外科杂志》2018年第1期38-42,共5页Orthopedic Journal of China

摘　　要：[目的]探讨肿瘤刮除植骨并可吸收螺钉固定治疗股骨头软骨母细胞瘤的手术方法和临床疗效。[方法]2002年8月~2014年11月,对11例股骨头软骨母细胞瘤患者行肿瘤刮除、自体髂骨移植并可吸收螺钉固定术。女性4例,男性7例,年龄12~27岁,平均18.55岁。手术采用S-P切口,脱位髋关节,于股骨头软骨处开窗,刮除肿瘤病灶,取自体髂骨块植骨并用可吸收螺钉1枚固定髂骨块。对所有患者进行随访,详细记录术后并发症、植骨愈合时间、肿瘤复发、髋关节功能等情况。应用髋关节Harris评分系统评估患者术前、术后功能。[结果]11例患者随访时间24~69个月,平均37个月。植骨愈合时间3~7个月,平均4.35个月。Harris评分由术前平均(65.53±9.32)分,增加至术后3个月的(85.15±4.23)分,优良率81.85%;术后1年(91.24±3.12)分,优良率100%;术后2年(92.62±3.18)分,优良率100%。术后3个月、1年、2年的Harris评分与术前相比差异均有统计学意义(P<0.05),术后1、2年的Harris评分与术后3个月相比差异均有统计学意义(P<0.05)。[结论]对于股骨头软骨母细胞瘤患者应用肿瘤刮除自体髂骨移植并可吸收螺钉固定术治疗,可以获得较低的并发症发生率及复发率、较短的植骨愈合时间以及满意的髋关节功能。[Objective] To investigate the surgical method and clinical outcome of the femoral head chondroblastoma treat- ed with curettage, bone grafting and absorbable screw fixation. [Methods] From August 2002 to November 2014, 11 patients with femoral head chondroblastoma were surgically treated with curettage, autogenous iliac bone grafting and absorbable screw fixation, including 7 males and 4 females aged from 12 to 27 years with an average of 18.5 years. The femoral head was exposed after anterior dislocation through t^ae Smith-Peterson approach. After the lesion identified and a fenestration conducted, the tu- mor lesion was completely curetted, subsequently autogenous bone graft harvested from the iliac crest was filled into the bone cavity, fixed with a absorbable screw. The postoperative complications, bone healing time, tumor recurrence and the hip func- tion in term of Harris score were recorded. [Results] All the 11 patients were followed up for 24 to 69 months with a mean of 37 months. The bone healing time ranged from 3 to 7 months with a mean of 4.35 months. The Harris score significantly increased from （65.53±9.32） on average preoperatively, to （85.15±4.23） the excellent rate of 81.85% at 3 months after surgery, to （91.24 ±3.12） with the excellent rate was 100% at 1 year, to （92.64±3.18） with the excellent rate of 100% at 2 years. The Harris scores at 3 months, 1 year, 2 years postoperative were significantly higher than the score before operation （P〈0.001）, addition- ally The Harris scores at 1 and 2 years postoperatively were statistically higher than the score at 3 months after operation （P〈 0.05） . [Conclusion] For treatment of chondroblastoma of the femoral head, this procedure, including curettage and autolo- gous iliac bone grafting and absorbable screw fixation, does obtain satisfactory outcome with lower complication rate and recurrence rate, shorter bone healing time and good hip func- tion.

关 键 词：股骨头 软骨母细胞瘤 刮除植骨 可吸收螺钉 

分 类 号：R738.1[医药卫生—肿瘤]