股骨远端疲劳骨折误诊教训

Misdiagnosis of tired fracture of distal segment of femur

目的提高对疲劳骨折的认识和诊断水平，避免误诊误治。方法报告和总结５例股骨远端疲劳骨折的诊治经验和误诊教训。结果５例患者均为男性，年龄１８～２３岁，病程３～６周，均有高强度运动史。经Ｘ线片检查及病理活检，初步诊断为骨肉瘤；后经仔细询问并分析病史，结合系列Ｘ线片观察，诊断为股骨远端疲劳骨折。经患肢适当制动和对症治疗，患者症状逐渐减轻或消失，均痊愈出院。随访７～１８个月，患者无异常。结论仔细询问病史，熟悉并掌握骨折愈合各阶段的形态学特征，以及正确的病理诊断，是避免误诊误治的关键。

Objective To improve the diagnosis of tired fracture of the distal segment of femur,and to avoid its misdiagnosis.Method Misdiagnosis of 5 patients with tired fracture of distal segment of the femur was reviewed.Result Five male patients, aged 18 to 23 years had the lesion for 3 to 6 weeks.They had long tough experience of sports. The lesion was considered at first as osteosarcoma by radiograph and biopsy. It was eventually diagnosed as tired fracture of distal segment of the femur. Symptoms were redieved or disappeared after proper treatment. Follow up for 7 to 18 months showed good results.Conclusion The key to avoid misdiagnosis and mistreatment of the fracture is to know its causes,morphological features of fracture healing, and correct pathologic diagnosis.