自固化CPC修复小儿良性骨肿瘤术后骨缺损

REPAIR OF BONE DEFECT DUE TO TUMOR RESECTION WITH SELF-SETTING CPC IN CHILDREN

目的总结自固化CPC修复小儿良性骨肿瘤术后骨缺损的临床效果。方法1998年12月-2006年12月收治32例良性骨肿瘤患儿。男21例,女11例;年龄4～14岁,平均9.8岁。病程3～18个月。其中非骨化性纤维瘤12例,骨囊肿8例,骨样骨瘤7例,骨纤维异样增殖症5例。骨缺损部位:股骨15例,胫骨8例,肱骨6例,其他部位3例。骨缺损范围为2.0cm×1.5cm×1.0cm～10.0cm×5.0cm×4.0cm。其中26例采用切开病灶刮除后以条状或颗粒状CPC填充缺损,填充量为3～23g;其中3例并发病理性骨折的患儿病灶清理后采用钢板固定,并行CPC植骨。6例骨囊肿先穿刺抽液,为淡黄色液,注入注射型CPC5～20mL。结果32例伤口均Ⅰ期愈合。所有患者均获随访,随访时间12～48个月,平均23.5个月。术后未出现过敏及毒性反应,无皮疹或高热,切口局部无疼痛或瘙痒感。术后4～9个月,平均7个月,X线片示植入的CPC与宿主骨直接愈合。患儿肢体活动正常。行内固定的患儿术后6～12个月拆除内固定。条状及颗粒CPC于术后8～36个月完全吸收,注射型CPC至最长随访48个月仍未完全吸收。无肿瘤复发。结论应用自固化CPC修复小儿良性骨肿瘤术后骨缺损是一种安全、经济和简便的方法。

Objective To summarize the effect of self-setting CPC on the repair of bone defect after tumor resection in children. Methods From December 1998 to December 2006, 32 patients with benign bone tumor were treated, and the bone defect was repaired by CPC. Among them, there were 21 males and 11 females, aged 4-14 years old （9.8 on average）. The course of disease was 3-18 months. There were 12 cases of non-ossifying fibroma, 8 of bone cyst, 7 of osteoid osteoma and 5 of fibrous dysplasia. The bone defect was located in femur in 15 cases, in tibia in 8 cases, in humerus in 6 cases and in other positions in 3 cases. The range of bone defect was 2.0 cm × 1.5 cm× 1.0 cm - 10.0 cm × 5.0 cm × 4.0 cm. CPC spongiosa granules of 3-23 g were filled in 26 cases, including 3 children with pathologic fracture and internal fixation with plate, and injectable CPC of 5-20 mL was filled in 6 bone cyst cases. Results Thirty-two patients obtained healing by first intertion. All the patients were followed up for 12-48 months （23.5 months on average）. No allergic reaction, toxicity, rash or high fever was found after operation. There was no pain or pruritus at the incisions. The X-ray films showed that the implanted CPC began to fuse with the host bone 4-9 months （7 month on average） after operation. The internal fixation was removed within 6-12 months of operation. And CPC spongiosa granules were absolutely absorbed within 8-36 months of operation. However, injectable CPC could be found 4 years after operation. The children＇s limbs could do normal exercises. Finally, bone matrix grew well and no recurrence was found. Conclusion CPC in repairing bone defect after benign bone tumor in children is a safe, economical, convenient and non-toxic method.