儿童特殊部位骨样骨瘤特点及手术疗效分析

Characteristics of osteoidosteoma in special position in children and the surgical treatment effect

目的探讨儿童特殊部位骨样骨瘤的临床特点及手术疗效、预后。方法选取2014年6月至2018年6月复旦大学附属儿科医院骨科治疗的46例儿童骨样骨瘤分析、遴选特殊部位骨样骨瘤,分析其分布、临床特点、影像学特点及治疗方法进行回顾性分析。结果本组病例41.30%为近关节的特殊部位骨样骨瘤,以松质骨型为主,滑膜炎症状明显,手术切除后症状均消失,无病理性骨折、关节畸形。结论特殊部位骨样骨瘤均位于近关节区域,其临床表现不典型,周缘骨质硬化少,但结合骨样骨瘤的临床特点、患病部位疼痛及影像学可见典型的瘤巢,对特殊部位骨样骨瘤的诊断并不困难,近关节及骨骺内骨样骨瘤瘤巢位于松质骨内,手术易刮除。

Objective To explore the characteristics,surgical efficacy,and prognosis of osteoidosteoma in special position in children.Methods 46 children with osteoidosteoma in special position were selected.The bone tumor samples were collected.Their distributions,clinical characteristics,radiologic characteristics,and therapy were analyzed. Results 41.30% of the patients got osteiodosteomas in the special parts of their proximaljoints, mainly cancellous bone type;their synovial inflammation was evident;the symptoms disappeared afteroperation;no pathological fracture and joint deformity occurred. Conclusions All osteoidosteoma in specialpositions locate in juxtaarticular portion;the clinical presentation is atypical, with little sclerosis. According tothe clinical features, pain in focal lesion, and nidus by radiographic findings, the diagnosis of osteoidosteoma inspecial positions is not difficult. Once the diagnosis is confirmed, operation should be carried out in early stageso as to avoid the obvious pain. The niduses of juxtaarticular and epiphyses are located in cancellous bone, and iseasy to be removed by surgery.