骨韧带样纤维瘤外科手术疗效分析

目的：探讨骨韧带样纤维瘤外科手术治疗效果。方法：自2000年6月至2010年6月，手术治疗15例骨韧带样纤维瘤患者，男4例，女11例；年龄18～64岁，平均39岁。部位分别是股骨上段4例、股骨下段3例、胫骨下段2例、肱骨上段1例、肱骨下段1例、肩胛骨1例、耻骨支1例、髂骨1例、胸骨柄1例。15例中1例行单纯病灶内刮除，14例按手术方式分两组，广泛切除组（7例），扩大刮除加灭活组（7例）。观察术后复发情况，采用Enneking功能评分对术后恢复情况进行评定。结果：15例患者均获随访，时间18～132个月，平均56个月。未发现转移。复发2例，1例为单纯病灶内刮除，1例为广泛切除组，复发率13．3％（2/15）。根据Enneking功能评估标准，广泛切除组术后（21．6±3．8）分，扩大刮除加灭活（28．3±1．3）分。广泛切除组优2例，良5例；扩大刮除加灭活组优7例。结论：扩大刮除加灭活手术较广泛切除组功能恢复更好，在重建较为困难的特殊部位建议优先考虑。

Surgical treatment for desmoplastic fibroma of bone

Objective: To discuss clinical effects of surgical treatment for desmoplastic fibroma of bone. Methods: Between June 2000 and June 2010,15 cases of desmoplastic fibroma were treated by surgical operation including 4 males and 7 females with an average age of 39 years old (ranged from 18 to 64 years old). The site of tumor was proximal femur in 4 cases,distal femur in 3,distal tibia in 2,proximal humerus in 1,distal humerus in 1,scapula in 1,pelvic in 2,manubrium of sternum in 1. The simple intralesional curettage was performed in 1 case. The other 14 cases were divided into two groups,7 cases had an aggressive curettage with inactivation and the last 7 cases had a wide resection. Recurrence condition were observed after operation. The function was valuated in two groups after the operation according to Enneking's standard. Results: The mean duration of follow-up was 56 months (ranged,18 to 132 months). Two cases recurred,but no metastasis. The patient with simple intralesional curettage recurreed,1 of the 7 patients with a wide resection recurred. The recurrence rate was 13.3%(2/15). There was no recurrence in the group with an aggressive curettage with inactivation. According to Enneking's standard,Enneking scoring was 21.6±3.8 in the group with a wide resection and 28.3±1.3 in another group,The results were excellent in 2 cases and good in 5 in the group with a wide resection,excellent in 7 in the other group. Conclusion: The aggressive curettage with inactivation has better functional recovery than the wide resection,and it should be chosen when the lesion is small or located in an area where reconstruction is difficult.