异体长骨干移植修复四肢骨囊肿合并病理性骨折

目的观察移植异体长骨干、骨板及钢板内固定治疗四肢骨囊肿合并病理性骨折的疗效. 方法 1996年1月～2002年4月,临床共收治12例四肢骨囊肿合并病理性骨折患者,囊肿4 cm×6 cm～3 cm×13 cm,平均3.6 cm×8.1 cm.切除囊肿前壁,刮除囊膜,植入经脱脂、脱蛋白的异体腓骨干或尺、桡骨干,用钢板或加对侧皮质贴附骨板,将自体骨、异体骨连成一体固定;术后外固定3周. 结果 12例术后伤口无红肿及渗液发生,均Ⅰ期愈合.随访1～4年,平均2.7年.骨囊腔愈合情况根据Capanna等评定标准进行评估,愈合9例,基本愈合3例;无复发,无不良反应发生.2例肱骨上段骨囊肿术后肩关节功能轻度受限,余10例患肢功能均恢复正常. 结论异体长骨干移植是修复四肢骨囊肿合并病理性骨折的安全、有效方法.

INTRACYSTIC ALLOGRAFT IN MANAGEMENT OF LONG BONE CYST MERGING PATHOLOGIC FRACTURE

OBJECTIVE: To investigate the efficiency of intracystic allograft fixed with bone plate and steel plate in management of long bone cyst merging pathologic fracture. METHODS: Twelve cases of long bone cysts with pathologic fractures were treated from January 1996 to April 2002. The median dimension of the cyst on the radiograph was 3. 6 cm x 8.1 cm. We regularly revealed the sites of cysts, cut the anterior wall, got cystic membrane away, implanted allo-bone fibula, ulna or radius shafts which were defatted and deproteined. The auto-bone and the allo-bone of all cases were fixed with bone plate and steel plate; external fixation was managed for 3 weeks after operation. RESULTS: All incisions achieved primary healing. All cases were followed up 2. 7 years on average. According to Capanna's standard, 9 cases completely healed, 3 cases basically healed, no cases recurred. The function in shoulder joint was slightly limited in 2 cases that cysts were located on the upper humerus, while that of the other 10 cases were recovered completely. CONCLUSION: Intracystic allograft fixed with bone plate and steel plate is safe and effective in management of long bone cyst merging pathologic fracture.