湖南省儿童医院先天性胫骨假关节的临床资料分析

发布时间：2018-04-24 22:32

  本文选题：先天性胫骨假关节 + 神经纤维瘤病　； 参考：《南华大学》2016年硕士论文

【摘要】：目的:先天性胫骨假关节是一种先天畸形,被列为儿童骨科最大的疑难症之一。本研究通过资料的整理分析,描述先天性胫骨假关节的临床资料特征。方法:回顾性分析2007年4月至2016年3月来湖南省儿童医院治疗的先天性胫骨假关节患者的临床资料,包括性别、侧别、假关节位置(胫骨上1/3、中1/3、下1/3)、腓骨状态(是否有假关节、假关节位置)、是否合并神经纤维瘤病、临床Crawford分型(I型、II型、III型、IV型)、第一次骨折年龄、分布区域、是否有神经纤维瘤病家族史。结果:共244例病例、249侧患肢,男170例,女74例。左侧119例,右侧120例,双侧均发生者5例。初次就诊时平均年龄为42.93±36.019(月)(范围:16天至17岁),其中初次就诊年龄段1岁-2岁,有74例,2岁-3岁年龄段,有44例,6岁-段及3岁-4岁段分别有43例、30例,其它年龄段有53例。假关节处第一次骨折的年龄的均值为16.77,标准差为15.867。假关节位置在胫腓骨上1/3者4例,在胫腓骨中1/3和胫腓骨下1/3者分别有107例、138例,其中CrawfordⅠ型11例,CrawfordⅡ型22例,CrawfordⅢ型31例,CrawfordⅣ型185例。有腓骨假关节者为146例,位置其中以腓骨下1/3最多,有141例,腓骨中1/3及腓骨上1/3分别有3例及2例。来源分布区域最多的是湖南省的51例,其次为山东省17例。有NF者148例。有NF家族史的病例数有15例。有、无NF家族史组NF的差异有统计学意义(P0.05),男性和女性组NF家族史、侧别、腓骨假关节的差异无统计学意义(P0.05),男性和女性组的NF差异有统计学意义(P0.05)。结论:湖南省儿童医院CPT患者男性多于女性,男女比约2.3:1,2%的病变累及双侧,主要位于胫腓骨中、下1/3,初次就诊年龄为42.93±36.019(月),第一次骨折年龄为16.77±15.867(月),60.7%合并NF,6.1%有NF家族史。CPT患者男性与女性的NF的发生率有差异,有NF家族史与无NF家族史的NF的发病率存在差异。而男性与女性的侧别构成、腓骨假关节的分布、NF家族史无差异。
[Abstract]:Objective: congenital pseudarthrosis of tibia is a congenital malformation, which is one of the most difficult diseases in pediatric orthopedics. This study describes the clinical features of congenital pseudarthrosis of tibia. Methods: the clinical data of congenital pseudarthrosis of tibia treated in Hunan Children's Hospital from April 2007 to March 2016 were analyzed retrospectively. Pseudoarticular position (1 / 3 of the upper tibia, 1 / 3 of the middle, 1 / 3 of the lower tibia), fibula status (whether there are pseudoarthrosis, pseudoarthrosis, and neurofibromatosis, clinical Crawford classification, type I, type II, type III, type IV), age of the first fracture, distribution area, Any family history of neurofibromatosis. Results: there were 244 cases (170 males and 74 females) with 249 affected limbs. There were 119 cases on the left side and 120 cases on the right side. The average age of the first visit was 42.93 卤36.019 (range: 16 days to 17 years old). Among them, the first visit age was 1 year -2 years old, 74 cases were 2 years old 3 years old, 44 cases were 6 years old and 30 cases were 3 years old, and there were 43 cases of 6 years old and 3 years old of 3 years old and 53 cases of other age groups. The mean age of the first fracture was 16.77 and the standard deviation was 15.867. There were 4 cases with 1 / 3 position of pseudarthrosis on tibia and fibula, 107 cases with 1 / 3 of tibia and fibula with 1 / 3 below tibia and fibula, including 11 cases of Crawford type 鈪，

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