组合式外固定器治疗儿童肱骨近端孤立性骨囊肿病理骨折

Using combined external fixator to treat solitary cyst of proximal humerus with pathological fracture

目的 评价组合式外固定器治疗儿童肱骨近端孤立性骨囊肿病理骨折的特点及治疗效果。方法 1 998年 6月～ 2 0 0 1年 1 2月应用组合式外固定器治疗肱骨近端骨囊肿病理骨折 1 2例 ,男7例 ,女 5例 ,年龄 5～ 1 4 .5岁 ,平均 8.7岁 ,平均随访 32 .6个月。骨囊肿处理采用刮除、50 %氯化锌烧灼、异体骨粒植骨充填。按Capanna标准评价骨囊肿术后X线改变。结果 骨囊肿愈合时间 3～ 8个月 ,1 2例中 8例完全愈合 ,3例留有X线透亮带 ,1例复发 ,所有病例均对治疗有反应 ,3例由于骨生长而需调节外固定杆的长度 ,无并发症发生。结论 组合式外固定器为儿童肱骨近端孤立性骨囊肿病理骨折提供了早期的稳定支架 ,不影响关节功能活动和骨骺生长 ,避免长期石膏固定的弊端 。

Objective To evaluate the characters an d results of combined external fixator to treat solitary cyst of the proximal hume rus with pathological fracture in children. Methods From June 1998 to December 2001, 12 cases (male 7 ,female 5) with solitary cyst of the proximal humerus with pathological fracture underwent combinative external fixator procedures. Their age ranged from 5 to 14.5 years with a mean of 8.7 years. The operative procedures included b ony cysts curettage with 50% zinc chloride cauterization; reduction and combined external fixation on humeral fracture in which filling with granular bony allo graft successively. Results All cases were followed-up 32.6 months.The h ealing period ranged from 3 to 8 months. According to the Capanna criteria, the postoperative X-ray examination of the cyst was evaluated as healed completely ( n =8); healed with residual lucent zone ( n =3) and relapse (1).A modulat ion of the combined external fixator had to be performed on 3 cases following th e bony growth. No major complications were observed on this group. Conclusion The advantages of combined external fixator ar e providing stability of pathological fracture; promotion of epiphyseal healing and limb movement, and avoidance of plaster cast fixation.