微创技术治疗青少年术后复发性骨囊肿

目的探讨微创技术治疗青少年术后复发性骨囊肿的疗效。方法1984年12月～2003年12月,对36例青少年术后复发性骨囊肿采用微创技术治疗,男19例,女17例;年龄9～21岁,平均15岁。囊肿大小2.5cm×6.0cm～3.5cm×13.0cm,平均3.0cm×8.0cm。位于肱骨近端18例,肱骨干10例,股骨粗隆及股骨颈部8例。既往手术次数:1次23例,2次10例,3次3例。复发距微创治疗时间5～13个月,平均6.5个月。治疗均在门诊进行,摄正侧位X线片定位,先将囊肿内积液吸出,然后注入醋酸氢化可的松乳剂,剂量根据囊肿大小而定。每隔3.5～4个月重复穿刺1次,直至痊愈。结果36例获随访3～18年,平均5年。穿刺次数3～11次,平均6次。疗效判定:痊愈,囊肿消失,由新生骨充填,26例;大部分愈合,囊肿大部分消失仅残留部分小于1cm的囊腔,经1年以上随访无扩大,6例;部分愈合,囊肿经多次治疗,囊腔明显缩小,但仍残留多个硬化的小囊肿腔,4例。无局部及全身并发症,无再手术病例。结论微创技术治疗青少年术后复发性骨囊肿,具有痛苦小、安全有效、医药费用少及勿需住院等优点。

MICROTRAUMATIC TECHNIQUE TREATMENT OF POSTOPERATIVE RECURRENT BONE CYSTS IN JUVENILE PATIENTS

OBJECTIVE: To study the effect of microtraumatic treatment of postoperative recurrent bone cysts in juvenile patients. METHODS: From December 1984 to December 2003, 36 cases of postoperative recurrent bone cysts after focal curettage and bone graft included 19 males and 17 females, aging 9-21 years with an average of 15 years. The size of bone cyst ranged from 2.5 cm x 6.0 cm to 3.5 cm x 13.0 cm with an average of 3.0 cm x 8.0 cm. The locations were proximal humerus in 18 cases, humeral shaft in 10 and femoral trochanteric region in 8. The focal curette and bone graft were given once in 23 cases, twice in 10 cases and 3 times in 3 cases. The interval between recurrence and microtraumatic treatment was 5-13 months (6.5 months on average). The posteroanterior and lateral X-ray films were taken to determine the location, range and feature of the focus. Under local anesthesia, 2 canulated needles were used; one was used to aspirate the contents of the cyst, the other was used to inject hydrocortisone acetate. The dose was determined according to the range of the focus. The treatment was repeated every 3. 5-4 months until the focus healed. RESULTS: All patients were followed up from 3 to 18 years with an average of 5 years. The microtraumatic treatment was repeated 3-11 times with an average of 6 times. Twenty-six cases healed completely, 6 cases healed significantly, and 4 cases healed partially. No local or general complications occurred during the treatment. CONCLUSION: This microtraumatic method for the treatment of postoperative recurrent bone cyst in juvenile patients has following advantages : less pain, easy manipulation, no hospitalization, low cost and definite effect.