改良活板门手术技术治疗股骨头软骨母细胞瘤  

Treatment of femoral head chondroblastoma with modified trapdoor technique

作　　者：单华超[1] 徐海荣[1] 李远[1] 牛晓辉[1] SHAN Hua-chao;XU Hai-rong;LI Yuan;NIU Xiao-hui(Department of Bone Tumors,Beijing Jishuitan Hospital,Beijing,100035,China)

机构地区：[1]北京积水潭医院骨肿瘤科,100035

出　　处：《中国骨与关节杂志》2021年第9期678-682,共5页Chinese Journal of Bone and Joint

摘　　要：目的股骨头软骨母细胞瘤的治疗仍然具有挑战性,本研究探讨改良活板门手术技术治疗股骨头软骨母细胞瘤的临床疗效。方法回顾性分析 1999 年至 2019 年,采用改良活板门手术技术治疗的 46 例股骨头软骨母细胞瘤患者的临床资料。其中男 30 例,女 16 例,平均年龄 17.8 岁 (8~30 岁)。评估临床表现、影像学表现,分析局部复发、并发症和功能。结果诊断时疼痛 34 例,不适 12 例。平均症状持续时间为 11.6 个月 (1~36 个月)。骨骺未闭合 6 例,闭合中 4 例,闭合 36 例。骨质破坏类型:Lodwick-1A 24 例,Lodwick-1B 19 例,Lodwick-1C 3 例。平均随访 51.2 个月 (9~140 个月),未见局部复发。2 例出现术后并发症,其中 1 例为股骨头缺血性坏死,最终接受人工股骨头置换术,另外 1 例在手术区域出现无症状的异位骨化。46 例均恢复正常生活,MSTS 功能评分 29.4 分 (范围 28~30 分)。结论改良活板门手术技术治疗股骨头软骨母细胞瘤安全、有效,值得在临床诊治中推荐。Objective The treatment of femoral head chondroblastoma is still challenging.This study aims to investigate the clinical efficacy of modified trapdoor technique in the treatment of femoral head chondroblastoma.Methods A series of 46 cases with femoral head chondroblastoma were treated by modified trapdoor technique from 1999 to 2019,including 30 males and 16 females with an average age of 17.8 years (range:8-30 years).Clinical manifestations,imaging findings,local recurrence,complications and functions were analyzed to evaluate the outcomes.Results There were 34 cases complaining pain and 12 cases claiming discomfort.The mean duration of symptoms was 11.6 months (range:1-36 months).Epiphysis was not closed in 6 cases,closing in 4 cases,and closed in 36 cases.Bone destruction types:Lodwick-1A in 24 cases,Lodwick-1B in 19 cases,Lodwick-1C in 3 cases.The mean follow-up was 51.2 months (range:9-140 months).No local recurrence was found.Postoperative complications occurred in2 patients;1 patient underwent artificial femoral head replacement due to femoral head avascular necrosis;1 patient had asymptomatic heterotopic ossification in the operative area.All 46 patients returned to normal life and the mean MSTS score was 29.4 (range:28-30).Conclusions The modified trapdoor technique is safe and effective in the treatment of femoral head chondroblastoma.It is worthy of recommendation for further clinical application.

关 键 词：骨肿瘤 软骨母细胞瘤 股骨头 治疗 预后 

分 类 号：R738.3[医药卫生—肿瘤]