BACKGROUND:Bisphosphonates that can suppress osteoclast activity strongly is a powerful inhibitor for bone resorption, which has been reported to have good effects in the treatment of fibrous dysplasia. OBJECTIVE:To evaluate the clinical effect of surgical treatment combined with bisphosphonate therapy in the treatment of fibrous dysplasia. METHODS: Fifteen patients with fibrous dysplasia of the long bone were subjected to surgical treatment and oral bisphosphonate therapy postoperatively. Limb pain, limb function, local X-ray manifestations and blood alkaline phosphatase activity were observed before and at 3, 6, 12, 24 months after treatment. The therapeutic effects were evaluated using modified Macnab standards. RESULTS AND CONCLUSION:Al the 15 patients were folowed up for more than 24 months, and their pain symptoms were significantly relieved after the combined treatment of surgery and bisphosphonates, excelent in 12 cases and effective in 1 case, and the total efficiency was 100%. X-ray films showed that the density slightly decreased in operation areas after 3 months, but at 6 months after treatment, the cortical bone was thickened and the marrow cavity density increased in the operation areas, and non-focal zone was continuously enlarged. No fractures and recurrence were found in al patients. At 6 months after treatment, the serum alkaline phosphatase activity decreased significantly (P < 0.05). The results suggest that surgical operation with bisphosphonate treatment for bone fibrous dysplasia can effectively inhibit the bone resorption, promote bone formation, increase the intensity of the lesion, reduce fractures and recurrence rate, so as to achieve a better therapeutic effect in clinic.%背景：双膦酸盐类药物具有较强的破骨细胞活性抑制作用，是强有力的骨吸收抑制剂，文献报告其在纤维结构不良患者的治疗中具有良好效果。 目的：评估外科治疗联合双膦酸盐类药物治疗纤维结构不良中的临床效果。 方法：四肢长骨纤维结构不良的患者15例，采用外科治疗及术后口服双膦酸盐类药物治疗。治疗前、治疗后3，6，12，24个月随访观察治疗后患肢疼痛、肢体功能、局部部位X射线表现及血碱性磷酸酶指标的变化，采用改良的Macnab疗效评定标准评价治疗效果。 结果与结论：15例患者均获得24个月以上随访。经外科治疗及双膦酸盐药物联合治疗后，患者疼痛症状明显改善：显效12例、有效3例，总有效率100%。患者病损区X射线片检查发现3个月后密度稍减退，但6个月后手术区骨皮质增厚、骨髓腔密度增加，无病灶区继续扩大。患者治疗后均未发生骨折及复发。治疗6个月，血清碱性磷酸酶明显降低(P<0.05)。结果提示外科手术配合双膦酸盐治疗骨纤维结构不良可有效抑制骨吸收，促进骨组织生成，增加病损区强度，降低外科治疗后骨折及病灶复发率，从而达到较好治疗效果。
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