股骨纤维结构不良伴重度内翻畸形的外科治疗论文.docVIP

　　股骨纤维结构不良伴重度内翻畸形的外科治疗论文 行斌斌，屠重棋，段宏，刘洋，裴福兴 【摘要】 ［目的］探索一种治疗股骨纤维结构不良伴重度髋或及股内翻畸形的有效外科方法。［方法］自2000年8月～2005年7月共收治13例14个股骨纤维结构不良伴重度髋或及股内翻畸形患者，均采用股骨单处或双处外翻截骨矫形、病灶刮除、打压植骨、重建钉内固定治疗。［结果］所有病人随访8～41个月（平均21个月）。X线显示，14个股内翻畸形股骨力线几乎完全矫正；髋内翻畸形的颈干角由术前平均75°（55°～100°）矫正为术后120°（95°～130°）；股骨相对长度由术前平均短缩3.4 cm（2.0～4.5 cm），矫正后延长2.8 cm（1.8～3.6 cm）；14个股骨共19处截骨面均达骨性愈合。所有患者植骨区于术后3个月均有不同程度的吸收.freelent of fibrous dysplasia of bone involving the femur ity Abstract：［Objective］To find an effective method of surgical treatment of fibrous dysplasia of bone involving the femur associated ity.［Method］Thirteen patients urs ity Feb 2002 and Jul 2005.Medial displacement of valgus or valgus osteotomies,curettage and allograft,reconstructional nail have been adolted to treat fibrous dysplasia of bone involving the femur ity.［Result］All patients 8 months to 41 months onths.Forteen femoral mechanical alignments（axis）had been corrected pletely rdiologically;the preoperative average neckshaft angle of 75°（range,55°～100°）,corrected to the average 120°（range,95 °～135°）of postoperative,the average shortening of the femur （range,2.0～4.5 cm）preoperatively,then enlongthened by 2.8 cm（range,1.8～3.6 cm）in postoperation.Ninteen location of osteotomies shour.All bone grafts onths and markedly at 10 to 14 months postoperatively.Preoperation,4 patients bulated oderate pain.All had no infections and recurrent fracture and progression of the deformity.［Conclusion］（1）This method can correct varus deformity,improve function,as echanical axis of femur.（2）It is able to effectively eradicate lesions and prevent recurrence.（3）Impaction allograft is the key of prompting allograft incorporating fully and preventing pathological fracture. Key ur; fibrous dysplasia of bone; varus deformity; osteotomy; allograft 骨纤维结构不良（fibrous dysplasia，FD），是一种以纤维、骨组织类肿瘤样增生为特点的非遗传性疾患，又称为骨纤维异样增殖症。最先由Lichtenstein于1938年提出，后经Jaffe详细描述并给予完善。按部位可分为单骨型和多骨型。本病好发于股骨近侧段，以畸形、跛行、疼痛和病理骨折为特点，严重影响患肢功能，甚至致残。 1 资料与方法 1.1 一般资料 自2000年8月～2005年7月本院共收治1