| 明小平,王小林,邵景范,等.应用弹性髓内钉治疗儿童长骨瘤样病变并病理性骨折.骨科,2016,7(3): 176-180,184. |
| 应用弹性髓内钉治疗儿童长骨瘤样病变并病理性骨折 |
| Application of elastic stable intramedullary nailing for treatment of partial tumor like lesions of long bones complicated by pathological fracture in children |
| 投稿时间：2015-10-13 |
| DOI：DOI：10.3969/j.issn.1674-8573.2016.03.008 |
| 中文关键词: 骨折固定术，髓内 儿童 瘤样病变 病理性骨折 |
| 英文关键词: Fracture fixation, intramedullary Child Tumor like lesion Pathological fracture |
| 基金项目:国家临床重点专科建设项目基金［国卫办医函（2013）544号］ |
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| 中文摘要: |
| 目的 探讨病灶刮除植骨结合弹性髓内钉（elastic stable intramedullary nailing, ESIN）内固定术治疗儿童长骨部分瘤样病变合并病理性骨折的疗效及特点。方法 2010年1月至2013年12月我院共收治长骨部分瘤样病变并病理性骨折患儿16例，均实施病灶刮除植骨并ESIN内固定术，通过术后X线片和临床随访两方面评价治疗效果：通过X线片评估病变骨骨折复位有无丢失及病灶愈合情况；采用肩、肘、髋、膝、踝等关节功能综合评价标准及随访患者的满意度进行临床评估。结果 16例患儿平均随访25.6个月。X线片显示病理性骨折均达骨性愈合，愈合时间为4~6个月，平均5个月。在随访过程中，病灶未出现复发或者再次骨折。术后平均12.5个月取钉。至末次随访时病灶完全消失（14例）或部分消失（2例）；患肢无疼痛，关节活动均不受限。结论 病灶刮除植骨结合ESIN内固定术可作为治疗儿童长骨部分瘤样病变并病理性骨折的有效方法。 |
| 英文摘要: |
| Objective To explore the effectiveness and advantages of elastic stable intramedullary nailing (ESIN) combined with curettage and graft for the treatment of partial tumor like lesions of long bones complicated by pathological fracture in children. Methods ESIN internal fixation combined with curettage and graft was used to treat partial tumor like lesions of long bones complicated by pathological fracture in 16 children between January 2010 and December 2013. The healing process was assessed by radiography and clinical follow-up. Radiographic assessment was performed on the scheduled follow-ups to examine bone fracture reduction and lesion healing. The clinical outcomes were evaluated using the comprehensive evaluation criteria of the shoulder, elbow, hip, knee, ankle, and patients’ satisfaction report at the final follow-up. Results All patients had a mean follow-up period of 25.6 months after surgery. Fractures healed completely at 4 to 6 months after operation (mean, 5 months). No recurrence or re-fracture was observed during the follow-up period. The ESIN was removed at a mean period of 12.5 months after operation. The lesion disappeared completely in 14 cases and partially in 2 cases. No pain of affected limb or motion limitation of joints was observed. Conclusion ESIN combined with curettage and graft can be as an effective method to treat children with long bone partial tumor like lesions complicated by pathological fracture. |
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