肢体动脉瘤样骨囊肿的手术治疗

目的评价肢体动脉瘤样骨囊肿的手术治疗及疗效。方法总结1991年2月至2004年2月经我院手术治疗的肢体动脉瘤样骨囊肿患者20例,其中男12例,女8例;年龄11~44岁,平均22.1岁。手术方法均采用病损局部开窗配合高速磨钻切刮术,术后腔内用石炭酸、75%酒精灭活。病损切刮术后骨缺损填充采用自体骨10例,异体脱钙骨2例,人工骨4例,骨水泥填塞4例。对于已经发生或可能发生病理性骨折的病损术后采用内固定,对于病损较小,不影响骨骼强度者不用内固定。本组15例行内固定术,5例未作内固定。结果20例患者均未出现感染或皮缘坏死等手术并发症。其中11例获随访,随访时间2~5年,平均2.6年。11例患者病损区植骨均愈合,患肢功能恢复良好,无一复发。结论动脉瘤样骨囊肿采用病损局部开窗配合高速磨钻切刮术,病损腔内灭活,可降低局部复发率。

The surgery of aneurysmal bone cysts in extremities

Objective To evaluate the surgery and its effect on aneurysmal bone cyst in extremities.Methods Summarize 20 cases with aneurysmal bone cyst in extremities treated with surgery at our hospital from Feb.1991 to Feb.2004.There were 12 males,8 females,with an average age of 22.1 years(range from 11 to 44 years).All patients underwent curettage,combined with a high-speed burr,cauterization of interior wall of the cyst using phenol and ethanol.Bone defect were filled with autogenous bone(10 cases),decalcified allogenous bone(2 cases),artificial bone(4 cases),bone cement(4 cases).After surgery all patients in whom pathological fractures had existed or might occur were treated with internal fixation.Five patients who had small lesions with no influence on skeleton strength were not treated with internal fixation.Fifteen cases were treated with internal fixation.Results After surgery no complications such as infection, skin edge necrosis were found in all patients.An average 2.6 years' follow-up(range from 2 to 5 years) was carried out in 11 cases.In these cases bone graft of lesion eventually healed with satisfactory function of affected extremities,without recurrence.Conclusion Aneurysmal bone cysts treated with curettage,combined with a high-speed burr,cauterization of interior wall of the cyst can lower local recurrence rate.