13例胫骨病灶清除灭活植骨术治疗胫骨骨纤维结构不良的临床资料分析

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摘要目的分析胫骨病灶清除灭活植骨术治疗胫骨骨纤维结构不良的临床资料。方法回顾性分析2009年1月～2017年12月福建医科大学附属第一医院骨科收治的13例胫骨骨纤维结构不良（OFD）患者的临床资料，患者均行胫骨病灶清除，保留胫骨后壁，所遗骨缺损以异体骨植骨。结果 13例患者术后病理均提示OFD，4例患者术后出现复发，其中3例再次接受手术后治愈，1例确诊复发后随访观察5年，病变保持稳定。≤5岁患者9例，4例复发；＞5岁患者4例，均无复发。7例患者进行了局部骨膜外切除，其中1例复发；7例患者进行了局部骨膜下切除，3例复发。6例患者出现手术并发症，其中3例为骨不连，2例为骨髓炎，1例为术后胫骨畸形，均再次手术治疗后治愈。需要特别注意的是，骨膜外切除的7例患者中，出现了更多的术后并发症（其中2例为骨髓炎，2例为骨不连）。结论大于5岁患者，建议行骨膜外切除。病灶清除后异体骨植骨操作简单，手术创伤小，但并发症较多。

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	梁福德

关键词 ：胫骨, 骨纤维结构不良, 病灶切除, 植骨术

Abstract：Objective To analyze clinical data of tibial lesion removal and inactivated bone grafting in the treatment of tibial fiber fibrous dysplasia.Methods From January 2009 to December 2017,retropective analysis of the clinical data of 13 patients with fibial fibrous dysplasia (OFD) in Department of Orthopedics,the First Affiliated Hospital of Fujian Medical University,and all patients underwent tibial lesion removal,the posterior wall of the tibia was retained.The remaining bone defect was grafted with allogeneic bone.Results Thirteen patients had postoperative pathological findings suggesting interfibrous dysplasia.Four patients relapsed after initial curettage.Three of them recovered after surgery.And one case was followed up for 5 years after diagnosis of recurrence,and the lesion remained stable.From the analysis of age,9 patients were ≤5 years old,and 4 patients relapsed;4 patients were ＞5 years old,all had no recurrence.From the perspective of surgery approach,7 patients underwent local extra periosteal resection,of which 1 patients relapsed;7 patients underwent local subperiosteal resection,and 3 patients recurred.Six patients had surgical complications,including 3 cases of nonunion,2 cases of osteomyelitis,and 1 case of tibial deformity,all of which were cured after reoperation.It is important to note that in the 7 patients undergoing extra periosteal resection,more postoperative complications occurred (2 patients of which were osteomyelitis and 2 patients were nonunion).Conclusion For patients older than 5 years,extraperiosteally resection is recommended.Allogeneic bone grafting is simple in operation and less invasive,but has more complications.Autologous fibula transplantation may be a better choice.

Key words： Tibia Bone fibrous dysplasia Lesion Resection Bone graft

作者简介: 梁福德(1990-)，男，汉族，福建三明人，硕士，住院医师，研究方向：骨科学

引用本文:

梁福德. 13例胫骨病灶清除灭活植骨术治疗胫骨骨纤维结构不良的临床资料分析[J]. 中国当代医药, 2020, 27(34): 94-96转100.
LIANG Fu-de. Analysis of clinical data of 13 cases of tibial focus debridement and inactivated bone grafting for treatment of tibial fibrous dysplasia. 中国当代医药, 2020, 27(34): 94-96转100.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2020/V27/I34/94

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