扩大刮除灭活植骨钢板内固定治疗儿童肱骨干骨囊肿伴病理性骨折25例  

25 Cases on Extended Curettage Inactivation and Bone Graft Plate Internal Fixation on the Treatment of Humerus Cyst with Pathological Fracture in Children

作　　者：胡永波[1] 劳永锵[1] 黎清斌 HU Yongbo;LAO Yongqiang;LI Qingbin(Department of Osteopathy,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong China.)

机构地区：[1]广东佛山市中医院骨病科,广东佛山528000

出　　处：《中国中医骨伤科杂志》2022年第5期63-67,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨扩大刮除灭活植骨钢板内固定治疗儿童肱骨干骨囊肿伴病理性骨折的临床疗效。方法:回顾性分析2015年1月至2019年6月收治的25例儿童肱骨干骨囊肿伴病理性骨折的患者资料。所有患者排除手术禁忌证后均行扩大刮除灭活植骨钢板内固定术治疗,术后随访采用骨囊肿X线愈合评价系统评估疗效,采用Constant-Murley肩关节功能评分评估肢体功能恢复情况,并记录术后相关并发症情况。结果:25例患者随访时间平均为(2.34±0.65)年,术口均I/甲愈合,均无术区疼痛、肌肉萎缩、肢体功能障碍、内固定断裂等并发症。术后1年Constant-Murley肩关节功能评分平均为(85.5±8.5)分,骨囊肿X线愈合评价系统评价结果:囊肿治愈20例,缺损治愈3例,持续存在1例,囊肿复发1例,治愈率为92%(23/25)。其中复发病例为14岁患者,于术后1年复查X线片发现病灶部分复发,行开窗病灶刮除灭活植骨术后治愈。结论:扩大刮除灭活植骨钢板内固定治疗儿童肱骨干骨囊肿伴病理性骨折可获得满意疗效。Objective:To retrospectively analyze the clinical efficacy of extended curettage,inactivation and bone graft plate internal fixation on the treatment of pediatric humeral shaft bone cyst with pathological fracture.Methods:The data of 25 pediatric patients with humeral shaft bone cyst with pathological fracture admitted from January 2015to June 2019were retrospectively analyzed.All patients were treated by extended curettage,inactivation and internal fixation with bone graft plate after the exclusion of surgical contraindications.Postoperative follow-up was performed with bone cyst X-ray healing evaluation system to evaluate efficacy and Constant-Murley score to evaluate limb function recovery,and postoperative complications were recorded.Results:25patients were followed up for average of(2.34±0.65)years.I/A healing was found in all operative ports.None of the 25patients had complications such as pain,muscle atrophy,limb dysfunction and rupture of internal fixation.Constant-Murley score of shoulder function 1year after surgery was(85.5±8.5).X-ray healing evaluation system for bone cysts showed that:cysts cured was 20cases,cured defect was 3cases,persistence was 1case,recurrent cysts was 1case.Among them,the recurrence case was a 14-years-old patient with partial recurrence of the lesion by reexamination of X-ray film one year after surgery and was cured after fenestration of the lesion by curettage,inactivation and bone grafting.Conclusion:Extended curettage,inactivation and bone graft plate internal fixation can achieve satisfactory results on the treatment of pediatric humeral shaft bone cyst with pathological fracture.

关 键 词：骨囊肿 肱骨干 病理性骨折 儿童 

分 类 号：R683.41[医药卫生—骨科学]