AO钛制弹性髓内钉结合自体骨髓囊腔注射治疗儿童长骨骨囊肿

摘要

Objective To study the effects and advantages of the treatment for simple bone cysts of the long bones in children with AO titanium elastic nail and autologous bone marrow injection. Methods Eighteen patients with a simple bone cyst at humerus or femur were managed with AO titanium elastic in-tramedullary nail combined with autologous bone marrow injection. There were eleven boys and seven girls in total, with the mean age of 8.1 years, ranged from 6 to 12 years. Twelve cysts was located in the proximal end of humerus, five in the proximal end of femur and one in the middle part of the shaft of femur. Twelve cysts were active and six inactive according to Neer standard. Radiographic evaluation was performed three, six, twelve and eighteen months after operation during the 11 to 23 months follow-up by taking anteroposteri-or and lateral X-ray pictures. Then we measured residual radiolucent areas on X-ray pictures and did statistic research with group comparison. Results Six cysts (33.3%) healed completely, and twelve (66.7%) healed with residual radiolucent areas which were visible on X-ray pictures 3 to 6 months after operation. Residual radiolucent areas on X-ray pictures gradually reduced during the different phases and it has statistical signif-icance by group comparison. There was no recurrence or major complication except for one patient with mild irritation of skin caused by the end of the nail up to now. Conclusion The treatment for simple bone cysts of the long bones in children combined with AO titanium elastic nail and autologous bone marrow injection not only has satisfactory healing rate but also can provide early stability to the long bones, and accelerate the healing of cysts which allows early mobilization and thus obviates the long-term need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture.%目的 探讨AO钛制弹性髓内钉结合自体骨髓囊腔注射治疗儿童长骨单纯性骨囊肿的疗效及特点.方法 肱骨、股骨单纯性骨囊肿患儿18例,男11例,女7例;年龄6～12岁,平均8.1岁;肱骨近端12例,股骨近端5例,股骨中段1例;按Neer等标准,活动期12例,静止期6例.使用AO钛制弹性髓内钉结合自体骨髓囊腔注射进行治疗.测量治疗后3、6、12、18个月的X线片示囊肿残留静止透光区面积并进行统计学分析,评估骨囊肿的愈合情况.结果 18例患儿均获得随访,随访时间11～23个月,平均16个月.骨囊肿愈合时间3～6个月,平均4.8个月.囊肿愈合6例(33.3%),缺损愈合12例(66.7%),愈合率100%.3、6、12、18个月X线片示囊肿残留静止透光区面积逐渐减小,各时间点比较差异有统计学意义.术后除1例患儿因钉尾刺激引起轻度皮肤激惹症状外,余均未发现其他并发症及病理性骨折.结论 AO钛制弹性髓内钉结合自体骨髓囊腔注射治疗儿童骨囊肿不仅囊肿愈合快,愈合率高,而且病灶骨能即刻获得力学稳定,同时可有效预防病理性骨折的发生.