股骨近端纤维结构不良的治疗分析

发布时间：2018-03-30 04:08

本文选题：股骨近端　切入点：纤维结构不良　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:分析股骨近端纤维结构不良(fibrous dysplasia of bone,FD)治疗后的临床效果,明确合理的手术方式是否可以降低纤维结构不良患者术后的并发症及复发。方法:回顾性选取2005年1月到2015年1月于山西医科大学第二医院就诊治疗并符合病理学诊断的股骨近端纤维结构不良患者40例,男18例,女22例,年龄14~49岁;单侧病变患者36例,双侧病变患者4例;病程1个月~8年,平均14个月,其中伴髋内翻畸形患者3例。40例患者中,10例患者采取静脉输注双磷酸盐药物治疗(药物组),30例患者采取外科手术治疗,其中采用病灶刮除灭活植骨术9例(第1组),采用病灶刮除灭活植骨内固定术18例(第2组),3例髋内翻畸形患者采用病灶刮除灭活植骨、截骨矫形术(第3组)。结果:40例病人均得到随访,时间12~134个月,平均随访时间24个月。随访期间4例(40%)服用药物患者及2例(6.67%)手术患者的治疗效果不佳,其他患者术后1年时髋关节功能均恢复良好,步态正常。所有患者无内固定物松动,行病灶刮除灭活植骨、截骨矫形术的患者,髋内翻畸形均得到矫正,12个月后Harris髋关节功能评分为83分、87分和94分。统计学方法比较后发现,药物组与手术组治疗处理后的复发率有显著差异(P0.05),患者的年龄、性别、及手术方式均对术后12个月时的Harris髋关节功能评分没有显著差异(P0.05)。结论:手术是治疗股骨近端纤维结构不良的一种确切有效方式,术后髋关节功能得到较好恢复,截骨矫形可治疗伴有髋内翻畸形的股骨近端纤维结构不良。
[Abstract]:Objective: to analyze the clinical effect of fibrous dysplasia of bonefinder (FDD) in the treatment of proximal femoral fibrous dysplasia. To determine whether a reasonable surgical procedure can reduce the postoperative complications and recurrence in patients with fibrous dysplasia. Methods: retrospective study was conducted in the second Hospital of Shanxi Medical University from January 2005 to January 2015. Forty patients with proximal femoral fibrous dysplasia were diagnosed. 18 males and 22 females aged 1449 years, 36 patients with unilateral lesions and 4 patients with bilateral lesions, the course of disease ranged from 1 month to 8 years (mean 14 months). Among them, 10 patients with hip varus deformity were treated by intravenous bisphosphate therapy (30 patients in the drug group were treated by surgical treatment). Among them, 9 cases were treated by focal curettage and inactivated bone grafting (group 1), 18 cases by focal curettage and inactivation of bone graft (group 2), 3 cases of hip varus deformity were treated by focal curettage and inactivation of bone graft. Results all 40 patients were followed up for 12 ~ 134 months, with an average follow-up time of 24 months. During the follow-up period, 4 patients took drugs and 2 patients took 6.67. The other patients had good hip function and normal gait one year after operation. All the patients had no loosening of internal fixation, and all patients underwent focal curettage and bone grafting, osteotomy and orthopedics. After 12 months Harris hip joint function score was 83 points 87 points and 94 points. Statistical analysis showed that there was significant difference in the recurrence rate between the drug group and the operation group after treatment (P0.05%, age, sex). There was no significant difference in Harris hip function score at 12 months after operation (P 0.05). Conclusion: operation is an effective method for the treatment of proximal femoral fibrous dysplasia, and the function of hip joint is better recovered after operation. Osteotomy can be used to treat proximal fibrous dysplasia of femur with hip varus deformity.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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