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[目的]探讨锁定加压接骨板治疗股骨远端良性骨肿瘤刮除植骨术后早期病理骨折的临床疗效。[方法]2006年3月～2010年3月,本科共收治11例股骨远端良性骨肿瘤刮除植骨术后早期病理骨折患者,男7例,女4例;年龄16～61岁,平均:42.7岁。原发肿瘤类型:内生软骨瘤2例;原发骨巨细胞瘤1例,软骨母细胞瘤4例,软骨粘液性纤维瘤3例,嗜酸性肉芽肿1例;自刮除植骨术后至发生骨折时间21～36 d,平均:22.3 d。AO股骨远端骨折分类:均为A1型,均行锁定加压接骨板(locking compression plate,LCP)内固定+植骨术治疗。[结果]1例发生浅表伤口感染,1例术后腘静脉血栓,治疗后好转。所有患者未发生免疫排斥反应,骨折复位丢失,内固定松动、折断,再骨折,肿瘤复发,继发性关节炎等合并症。随访时间12～61个月,平均34.4个月。膝关节功能均恢复至正常活动范围,屈曲120°～135°,过伸0°～5°;MSTS下肢评分28～30分,平均28.9分。[结论]锁定加压接骨板能够满足对此类特殊骨折治疗的要求,特别是利用内固定支架的特性,固定后仍能完成充分植骨的操作,并尽可能的减少二次手术对局部骨折端组织的损伤。内固定力学性能合理,固定可靠,有助于骨折愈合和瘤腔植骨的修复,并可适当的进行早期功能练习,恢复膝关节功能,是治疗良性骨肿瘤刮除植骨术后早期病理骨折有效的内固定方法。
[Objective] To investigate the clinical effect of locking compression plate in the treatment of early pathological fracture after bone grafting of benign bone tumors of distal femur. [Methods] From March 2006 to March 2010, 11 patients with benign bone tumors distal to the femoral bone were treated with early pathological fracture after bone grafting. There were 7 males and 4 females, aged 16-61 years : 42.7 years old. Primary tumor types: 2 cases of endogenous chondroma; 1 case of primary giant cell tumor of bone, 4 cases of chondroblastoma, 3 cases of cartilage myxoid fibroma and 1 case of eosinophilic granuloma; Fracture time to 21 ~ 36 d, average: 22.3 d. AO distal femur fracture classification: all A1 type, all underwent locking compression plate (LCP) fixation and bone graft. [Results] One case had superficial wound infection and one case had postoperative phlebothrombosis, which improved after treatment. All patients did not occur immune rejection, loss of fracture reduction, internal fixation loosening, fracture, and then fracture, tumor recurrence, secondary arthritis and other complications. Follow-up time was 12 to 61 months, an average of 34.4 months. Knee function were restored to normal range of motion, flexion 120 ° ~ 135 °, over-stretched 0 ° ~ 5 °; MSTS lower extremity score 28 to 30 points, an average of 28.9 points. [Conclusion] Locked compression plate can meet the requirements of this kind of special fracture treatment. In particular, the characteristics of the internal fixation stent can be used to complete the operation of full bone graft after fixation, and reduce the secondary operation to local fracture Tissue damage. The mechanical properties of the internal fixation are reasonable, reliable and reliable, which will be helpful for the healing of fractures and the repair of the tumor in the tumor cavity. The early functional exercises and the restoration of the knee joint function may be appropriate for the treatment of early pathological fractures of the benign bone tumors after bone grafting Effective method of internal fixation.