BACKGROUND Fibrous dysplasia is a congenital disorder in which normal bone is replaced by fibro-osseous tissue or irregular trabeculae of woven bone intermixed with mature collagenous tissue.A single or multiple bones...BACKGROUND Fibrous dysplasia is a congenital disorder in which normal bone is replaced by fibro-osseous tissue or irregular trabeculae of woven bone intermixed with mature collagenous tissue.A single or multiple bones are affected.This rare bone disorder has three clinical patterns including monostotic,polyostotic,and that associated with McCune-Albright syndrome.Most studies report primary fibrous dysplasia.However,a few cases of recurrent monostotic fibular fibrous dysplasia have been reported.Here,we report a therapeutic strategy for recurrent fibular fibrous dysplasia.CASE SUMMARY A 4-year-old boy was admitted for persistent pain in the left lower limb and abnormal gait over the previous 9 mo.He had no history of present or past illness.Preoperative imaging data showed erosion-like changes with bone expansion of the left middle and lower fibular segment.Tumor tissue in the fibular bone marrow cavity was removed by curettage,and rapid intraoperative pathological examination suggested fibular fibrous dysplasia.An allograft was implanted into the fibular medullary cavity.However,he was readmitted with clinical symptoms including persistent pain,abnormal gait,and local swelling at the age of 6 years.He was diagnosed with recurrent fibular fibrous dysplasia based on the second medical examination.He underwent fibular bone tumor radical resection and longus fibular allograft transplantation combined with fibular bone locking plate and screws.Good host bone to allogenic bone graft fusion was observed by the physician on postoperative regular follow-up.CONCLUSION Radical resection of fibrous dysplasia and longus fibula allograft combined with internal fixation for reconstruction are suitable for the treatment of recurrent monostotic fibular fibrous dysplasia.展开更多
[目的]探讨采用髓芯减压异体腓骨支撑移植治疗股骨头坏死(osteonecrosis of the femoral head,ONFH)的临床疗效。[方法]回顾性分析2018年6月—2020年6月本院就诊的ONFH患者的临床资料,根据医患沟通结果,43例采用髓芯减压+同种异体骨植...[目的]探讨采用髓芯减压异体腓骨支撑移植治疗股骨头坏死(osteonecrosis of the femoral head,ONFH)的临床疗效。[方法]回顾性分析2018年6月—2020年6月本院就诊的ONFH患者的临床资料,根据医患沟通结果,43例采用髓芯减压+同种异体骨植入结合异体腓骨支撑术(支撑组),27例采用髓芯减压术(未支撑组)。比较两组围手术期、随访及影像结果。[结果]支撑组手术时间[(55.1±9.2)min vs(40.3±10.3)min,P<0.001]、切口总长度[(5.5±0.6)cm vs(3.1±0.7)cm,P<0.001]、术中失血量[(33.7±5.0)ml vs(30.9±4.6)ml,P=0.022]、术中透视次数[(4.2±1.0)次vs(3.6±1.0)次,P=0.017]均显著多于未支撑组(P<0.05),但前者切口愈合情况[例,甲/乙/丙,(30/10/3)vs(10/9/8),P=0.010],下地行走时间[(3.4±0.4)d vs(4.6±0.7)d,P<0.001]和住院天数[(4.8±0.9)d vs(7.1±1.3)d,P<0.001]均显著优于后者。两组均随访24个月,术后支撑组的ARCO分级、骨水肿和关节积液征的程度均显著改善(P<0.05),但T?nnis分期无显著变化(P>0.05)。术后未支撑组的上述指标均无显著变化(P>0.05)。两组术前、术后6个月上述指标的差异均无统计学意义(P>0.05),术后24个月时,支撑组的ARCO分级[例,I/II/III/IV,(29/12/2/0)vs(11/10/6/0),P=0.030]、骨水肿[(例,<15%/15%~30%/≥30%),(34/8/1)vs(14/10/3),P=0.044]和关节积液征[例,0/1/2/3,(30/11/2/0)vs(10/14/3/0),P=0.026]均显著优于未支撑组。[结论]在治疗ONFH方面,通过髓芯减压+同种异体骨植入结合异体腓骨支撑术,具有明显的优势,并取得较理想的临床效果。展开更多
基金The Scientific and Technological Innovation Platform of Huaihua,China,No.2022F2701The Science and Technology Planning Project of Huaihua,China,No.2021R3117.
文摘BACKGROUND Fibrous dysplasia is a congenital disorder in which normal bone is replaced by fibro-osseous tissue or irregular trabeculae of woven bone intermixed with mature collagenous tissue.A single or multiple bones are affected.This rare bone disorder has three clinical patterns including monostotic,polyostotic,and that associated with McCune-Albright syndrome.Most studies report primary fibrous dysplasia.However,a few cases of recurrent monostotic fibular fibrous dysplasia have been reported.Here,we report a therapeutic strategy for recurrent fibular fibrous dysplasia.CASE SUMMARY A 4-year-old boy was admitted for persistent pain in the left lower limb and abnormal gait over the previous 9 mo.He had no history of present or past illness.Preoperative imaging data showed erosion-like changes with bone expansion of the left middle and lower fibular segment.Tumor tissue in the fibular bone marrow cavity was removed by curettage,and rapid intraoperative pathological examination suggested fibular fibrous dysplasia.An allograft was implanted into the fibular medullary cavity.However,he was readmitted with clinical symptoms including persistent pain,abnormal gait,and local swelling at the age of 6 years.He was diagnosed with recurrent fibular fibrous dysplasia based on the second medical examination.He underwent fibular bone tumor radical resection and longus fibular allograft transplantation combined with fibular bone locking plate and screws.Good host bone to allogenic bone graft fusion was observed by the physician on postoperative regular follow-up.CONCLUSION Radical resection of fibrous dysplasia and longus fibula allograft combined with internal fixation for reconstruction are suitable for the treatment of recurrent monostotic fibular fibrous dysplasia.
文摘[目的]探讨采用髓芯减压异体腓骨支撑移植治疗股骨头坏死(osteonecrosis of the femoral head,ONFH)的临床疗效。[方法]回顾性分析2018年6月—2020年6月本院就诊的ONFH患者的临床资料,根据医患沟通结果,43例采用髓芯减压+同种异体骨植入结合异体腓骨支撑术(支撑组),27例采用髓芯减压术(未支撑组)。比较两组围手术期、随访及影像结果。[结果]支撑组手术时间[(55.1±9.2)min vs(40.3±10.3)min,P<0.001]、切口总长度[(5.5±0.6)cm vs(3.1±0.7)cm,P<0.001]、术中失血量[(33.7±5.0)ml vs(30.9±4.6)ml,P=0.022]、术中透视次数[(4.2±1.0)次vs(3.6±1.0)次,P=0.017]均显著多于未支撑组(P<0.05),但前者切口愈合情况[例,甲/乙/丙,(30/10/3)vs(10/9/8),P=0.010],下地行走时间[(3.4±0.4)d vs(4.6±0.7)d,P<0.001]和住院天数[(4.8±0.9)d vs(7.1±1.3)d,P<0.001]均显著优于后者。两组均随访24个月,术后支撑组的ARCO分级、骨水肿和关节积液征的程度均显著改善(P<0.05),但T?nnis分期无显著变化(P>0.05)。术后未支撑组的上述指标均无显著变化(P>0.05)。两组术前、术后6个月上述指标的差异均无统计学意义(P>0.05),术后24个月时,支撑组的ARCO分级[例,I/II/III/IV,(29/12/2/0)vs(11/10/6/0),P=0.030]、骨水肿[(例,<15%/15%~30%/≥30%),(34/8/1)vs(14/10/3),P=0.044]和关节积液征[例,0/1/2/3,(30/11/2/0)vs(10/14/3/0),P=0.026]均显著优于未支撑组。[结论]在治疗ONFH方面,通过髓芯减压+同种异体骨植入结合异体腓骨支撑术,具有明显的优势,并取得较理想的临床效果。
