糖皮质激素注射联合弹性钢针固定治疗股骨近端单纯骨囊肿的初步观察

Preliminary treatment of proximal femur bone cysts by glucocorticoid injection plus elastic intramedullary nailing

目的初步探讨糖皮质激素囊腔内注射联合弹性髓内针髓腔内固定治疗股骨近端单纯骨囊肿的效果。方法回顾性分析重庆医科大学附属儿童医院2013年4月至2015年11月收治的25例股骨近端单纯骨囊肿患儿资料,患儿均行穿刺抽吸囊液,无水酒精灭活囊壁细胞,采用醋酸泼尼松囊腔内注射联合弹性髓内针髓腔内固定的手术方式。术后拍摄X线片,并结合Capanna提出的诊断标准随访治疗效果。结果 25例股骨近端单纯骨囊肿患儿中,合并病理性骨折21例,活跃型骨囊肿19例。术后平均随访11. 6个月(6～30个月)。10例完全治愈(CapannaⅠ),14例部分治愈(CapannaⅡ),1例复发(CapannaⅢ)。患儿术后均未出现患肢发育畸形等并发症。结论糖皮质激素囊腔内注射联合弹性髓内针髓腔内固定治疗股骨近端骨囊肿具有创伤小、术后患肢功能恢复较快、患肢发育畸形及生长停滞发生率低等特点,初步治疗效果较为理想。

Objective To explore the treatment efficacy of proximal femur simple bone cysts with elastic intramedullary nailing immobilization in cavummedullare plus glucocorticoid injection.Methods Retrospective analysis was performed for 25 children of simple bone cysts of proximal femur undergoing elastic intramedullary nailing immobilization and glucocorticoid injection from April 2013 to November 2015.The treatment efficacy was evaluated with X-ray and Capanna diagnostic standard.Results Radiographic evidence indicated that 10 cysts consolidated completely(CapannaⅠ)and 14 cysts consolidated partially(CapannaⅡ).And one cyst reappeared(CapannaⅢ).Conclusion The preliminary results of elastic intramedullary nailing immobilization plus glucocorticoid injection are encouraging for simple bone cysts of proximal femur.There are advantages of minimal trauma,rapid functional recovery and no growth impairing.