股骨近端纤维结构不良的手术治疗

目的探讨股骨近端纤维结构不良的手术治疗方式。方法对19例股骨近端纤维结构不良的不同手术治疗方式及术后疗效进行回顾性分析。结果1例术后3d引流管口渗出血清样物质，加强抗感染、营养支持及换药处理后愈合。19例均获随访，时间13—58个月。复查X线片见缺损修复区内有新骨生成改变，骨折处骨愈合；1例术后20个月因外伤致股骨转子下内固定物旁骨折再次手术发现肿瘤复发，行再次刮除植骨内固定术后14个月愈合；除1例未行内固定的病例外，余患者术后患肢功能均得到良好恢复，8—12个月可弃拐行走。结论股骨近端纤维结构不良应积极手术治疗，在彻底刮除病变和充分植骨的基础上，强调内固定的应用。

Surgical treatment of fibrous dysplasia in proximal femur

Objective To study the surgical treatment of fibrous dysplasia in proximal femur. Methods A retrospective analysis was made on surgical treatment and operation results of 19 cases with fibrous dysplasia in proximal femur. Results Wound effusion occurred in one ease in 3 days after operation, and healed by antibiotic treatment,nutrition supplement and dress changing. The patients was followed up for 13 - 58 months with an average of 31 months. X-ray film of postoperation showed bone union in defect. Only one case had relapse with proximal femur fracture near the plate, and healed in 14 months after reoperation. Except 1 without internal fixation, the functional results were good in 18 cases, who could walk without external supports in 8 - 12 months after operation. Conclusions Surgical treatment is reliable therapy to fibrous dysplasia in proximal femur, and on the base of complete curettage and bone grafting , internal fixation may play an important role.