异体骨移植治疗纤维结构不良疗效分析

Curative effects of allogenic bone transplantation on fibrous dysplasia

目的对异体骨移植内固定术治疗纤维结构不良的效果进行分析总结。方法对2001年1月～2011年12月在我院行异体骨移植内固定手术治疗的52例纤维结构不良病例进行回顾性分析,其中男性27例,女性25例,平均27.1(8～70)岁;单发46例,多发6例;股骨24例(股骨近端18例),胫骨16例,肱骨8例,其他部位4例。临床表现:疼痛34例,病理性骨折8例,畸形5例,肿块2例,其他3例。平均病程2.8年(2个月～11年)。采用病灶彻底刮除、同种异体骨植骨及内固定术,对伴有畸形者同时予以截骨矫形。结果 42例患者平均随访2.4年(6个月～9年)。3例患者出现植骨吸收,其中1例截骨矫形出现钢板螺钉松动。结论彻底病灶刮除、同种异体植骨及有效的内固定是治疗纤维结构不良的有效方法。

Objective To analyze the effects of internal fixation by allogenic bone transplantation on fibrous dysplasia（FD）.Methods A retrospective analysis was made in 52 cases of FD that received the internal fixation by allogenic bone transplantation in our hospital from January 2001 to December 2011.There were 25 female cases and 27 male ones,and the average age was 27.1 ranging from 8 to 70.Forty six cases were monostotic FD,and 6 ones were polyostotic FD.Femur was involved in 24 cases（proximal femur was involved in 18 ones）;tibia was involved in 16 cases;humerus was involved in 8 ones;other parts were involved in 4 ones.The clinical manifestations included pain（34 cases）,pathologic fracture（8 ones）,deformity（5 ones）,tumors（2 ones）,and others（3 ones）.The average course of disease was 2.8 years（2 months to 11 years）.Treatments included complete curettage of focuses,allogeneic bone grafting,and internal fixation.Osteotomy was used in patients with FD combined with deformity.Results Follow-up was made in 42 patients for the average time of 2.4 years（6 months to 9 years）.Bone resorption occurred in 3 cases in which plate-screw loosening occurred in one.Conclusion Complete curettage of focuses,allogeneic bone grafting,and effective internal fixation are effective methods for the treatment of FD.