摘要
目的分析不典型骨纤维结构不良的临床特点和可能导致误诊的原因。方法总结1991--2007年经我院手术治疗的不典型骨纤维结构不良患者24例，其中男13例，女11例；年龄4～65岁，平均26岁。单发19例，多发5例。并发病理性骨折6例。本组手术治疗方法有行单纯病灶切除术2例；病灶切除带血管腓骨重建胫骨术1例；单纯病灶切刮术4例；病灶切刮骨水泥填塞术6例；病灶切刮髂骨植骨术2例；切刮同种异体骨移植术4例；病灶切刮人工骨植骨术2例。使用气磨钻行病灶切刮术的2例，接受植骨术的15例中3例采用内固定治疗。结果24例患者均未出现感染或皮缘坏死等手术并发症。其中20例获随访，随访时间16个月～17年，平均9．5年。20例患者病损区均无复发、恶变及术后病理性骨折，植骨处均愈合，患肢功能恢复良好。结论不典型骨纤维结构不良临床表现多样，常规影像学检查（包括MRI）仍缺乏特异性表现，采用病损局部C臂透视下配合高速磨钻切刮术对瘤灶彻底清除，可降低局部复发率。
Objective To analyze the clinical character and the possible reason for misdiagnosis of untypical osteofibrous dysplasia. Methods Summarize 24 cases with untypical osteofibrous dysplasia treated with surgery at our hospital from 1991 to 2007. There were males 13 cases,female 11 cases,with an average age of 26 years （range from 4 to 65 years）. 19 cases occurred with mono lesion,5 cases with multiple lesions. 6 of 24 cases combined with pathological fracture. Surgery methods included curettage, resection, in which 2 cases combined with a high speed burr. Bone defect were treated using autogenous bone （2 cases ）, decalcified allogenousbone （4cases）, artificial bone （2 cases）, bone cement （6 cases） and fibular autograft with vascular （lcases）. 3 of 15 cases who underwent bone graft were treated with internal fixation. Results After surgery no complications such as infection, skin edge necrosis were found in all patients. An average 9.5 years＇ follow up （ range from 16months to 17 years） was carried out in 20 cases. Bone graft cases eventually healed with satisfactory function,without recurrence,canceration or refracture. Conclusion Untypical osteofibrous dysplasia underwent different clinical appearance. General imaging exam （include MRI） had limited diagnostic value.Curettage combined with a high speed burr under C-arm fluoroscopy could decrease the local recurrence rate.
出处
《同济大学学报（医学版）》
CAS
2009年第1期69-72,共4页
Journal of Tongji University(Medical Science)
