开放切除手术治疗股骨小转子部骨样骨瘤的疗效分析

Therapeutic effect analysis for open resection in osteoid osteoma around lesser trochanter of femur

目的：探讨股骨小转子部骨样骨瘤的影像学特点和开放切除术治疗的疗效。方法：回顾性分析2013年7月至2015年8月在中南大学湘雅二医院接受开放切除手术治疗的股骨小转子部骨样骨瘤患者14例，男9例，女5例，年龄9～44（平均20）岁，病程3～36（平均8）个月。术前完善X线、CT和MRI检查，术后3个月内避免剧烈运动。结果：14例患者中皮质型骨样骨瘤9例，骨膜型5例。9例患者可在X线片发现瘤巢，14例患者CT均可发现瘤巢。14例患者术前未服用非甾体抗炎药的情况下，视觉模拟评分（visual analogue scale，vAs）平均6．5分。随访9～34（平均20）个月。患者术后1个月VAS平均0分，随访中无疼痛症状复发，无感染，无血管神经损伤和骨折等并发症发生。结论：开放切除手术治疗股骨小转子部骨样骨瘤，术后复发率低，并发症少，是一种较好的治疗方法。

Objective： To evaluate the radiological features of osteoid osteoma around lesser trochante of femur, and to analyze the outcomes of treatment with open surgery. Methods： From July 2013 to August 2015, 14 patients （9 males, 5 females） with osteoid osteoma around lesser trochanter were retrospectively reviewed. The ages of patients were 9-44 （average 20） years old. The duration of symptom was 3-36 （average 8） months. After the X-ray plain radiography~ CT and MR, all patients underwent open resection. No intense exercise was allowed in the first three months after the operation. Results： There were 9 cases of cortical type, and 5 cases of subperiosteal type. The niduses were found by plain radiographs in 9 patients. By CT scan, the niduses were found in all 14 patients. The average pre-operative visual analogue scale （VAS） without NSAIDs was 6.5. One month after the operation, the average VAS was 0 for all patients. ＂Ihe follow up time for all patients was 9-34 （average 20） months. No recurrence, infection, neurovascular injury or fracture was found during the follow up. Conclusion： Open resection is a feasible method for osteoid osteoma around lesser trochanter of femur with satisfied outcome and low complication rate.