摘要
[目的]探讨锁定加压接骨板治疗股骨远端良性骨肿瘤刮除植骨术后早期病理骨折的临床疗效。[方法]2006年3月～2010年3月,本科共收治11例股骨远端良性骨肿瘤刮除植骨术后早期病理骨折患者,男7例,女4例;年龄16～61岁,平均:42.7岁。原发肿瘤类型:内生软骨瘤2例;原发骨巨细胞瘤1例,软骨母细胞瘤4例,软骨粘液性纤维瘤3例,嗜酸性肉芽肿1例;自刮除植骨术后至发生骨折时间21～36 d,平均:22.3 d。AO股骨远端骨折分类:均为A1型,均行锁定加压接骨板(locking compression plate,LCP)内固定+植骨术治疗。[结果]1例发生浅表伤口感染,1例术后腘静脉血栓,治疗后好转。所有患者未发生免疫排斥反应,骨折复位丢失,内固定松动、折断,再骨折,肿瘤复发,继发性关节炎等合并症。随访时间12～61个月,平均34.4个月。膝关节功能均恢复至正常活动范围,屈曲120°～135°,过伸0°～5°;MSTS下肢评分28～30分,平均28.9分。[结论]锁定加压接骨板能够满足对此类特殊骨折治疗的要求,特别是利用内固定支架的特性,固定后仍能完成充分植骨的操作,并尽可能的减少二次手术对局部骨折端组织的损伤。内固定力学性能合理,固定可靠,有助于骨折愈合和瘤腔植骨的修复,并可适当的进行早期功能练习,恢复膝关节功能,是治疗良性骨肿瘤刮除植骨术后早期病理骨折有效的内固定方法。
[Objective]To determine the clinical efficacy of locking compression plate in early stage pathological fracture after curettage and grafting of the benign distal femur tumor. [Method]Our department had treated 11 patients with early stage pathological fracture after curettage and grafting of the benign distal femur tumor,including 7 male and 4 female patients with the average age of 42.7 years whose ages ranging from 16 to 61 years.The types of primary tumor in these patients were：2 patients with enchondroma,1 with primary osteoclastoma,4 with chondroblastoma,3 with chondromyxoid fibroma of bone,1 with eosinophilic granulomatosis.The times between the curettage and grafting to the fracture were from 21 to 36 days with the average time of 22.3 days.The types of distal femur fracture in these patients were all type A1 who were treated with evenly locking compression plate,internal fixation and bone grafting. [Result]One patient in 11 had infection in wound,another had blood clots in popliteal vein after surgery which improved within treatment.No patients had complications as immunological rejection,incorrect reduction of fracture,loosening and rupture of internal fixation,refracture,tumor recurrence and secondary arthritis.The follow-up time were 12 to 61 months with average follow-up time of 34.4 months.Their knee joint functions all returned to normal range of activity including the flexion of 120°to 135°and the hyperextension of 0°to 5°,MSTS lower extremity scores were 28-30 points with average scores of 28.9 points. [Conclusion]The internal fixation of locking compression plate has good mechanical property with fixedness and reliableness which contributes to the healing of facture and the restoration of tumor cavity grafting.Besides,it could assist functional practice in early stage to restore knee joint function.The locking compression plate is a potent internal fixation for early stage pathological fracture after curettage and grafting of the benign distal femur tumor.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2012年第4期317-320,共4页
Orthopedic Journal of China
关键词
肿瘤
股骨远端
骨折
锁定加压接骨板
neoplasms
distal femur
fracture
locking compression plate
