Pronounced femur malunion after pathological bone fracture due to a simple bone cyst in the shaft of the femur, treated using Ilizarov fixation: a case report.
Pronounced femur malunion after pathological bone fracture due to a simple bone cyst in the shaft of the femur, treated using Ilizarov fixation: a case report.
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DOI：
10.1186/s13256-018-1710-3
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发表时间：
2018-06-21
影响因子：
1
通讯作者：
Kanaji A
中科院分区：
文献类型：
--
作者：
Nishiwaki T;Uchikawa S;Kusakabe H;Seki A;Eguchi Y;Takayama S;Oya A;Nakamura M;Matsumoto M;Kanaji A
虽然一个简单的骨囊肿有病理性骨折的风险，但很少导致严重的畸形。在此我们报告一例单纯性骨囊肿导致的多发性病理性骨折后股骨严重畸形，并考虑了尽管多次治疗，畸形愈合进展的原因。最后，我们提出了畸形愈合矫正的治疗方案。一个9岁7个月大的日本女孩被转诊到我们的机构，她的右股骨明显畸形，由多个简单的骨囊肿相关的病理性骨折引起。畸形包括股骨干中间三分之一处弯曲约90°和内旋60°。为了纠正这种畸形，我们切除了病变，从而缩短了股骨，然后纠正了对线，并应用了Ilizarov固定器来延长骨。目前，手术后3年，畸形没有复发，我们的病人生活在没有任何限制的日常活动或定期锻炼。当长骨处于长期变形状态时，畸形不仅随着骨骼的生长而发展，而且软组织保持不平衡，治疗变得越来越困难。为了防止骨畸形和脆性增加，应尽快使用髓内钉或其他固定技术矫正畸形。我们相信，我们的缩短-牵引方法是有效的治疗严重畸形与不平衡的软组织。
Although a simple bone cyst carries the risk of pathological fractures, it rarely causes severe deformity. Here we report a case of severe femoral deformity after multiple pathological fractures due to simple bone cysts, and consider the reason for the progression of malunion despite multiple previous treatments. Finally, we propose a treatment option for malunion correction. A 9-year, 7-month-old Japanese girl was referred to our facility with obvious deformity of her right femur, caused by multiple simple bone cyst-related pathological fractures. The deformity included bowing of approximately 90° and an internal rotation of 60° in the middle third of the femoral shaft. To correct this deformity, we excised the lesion, thus shortening the femur, then corrected the alignment and applied an Ilizarov fixator to extend the bone. At present, 3 years after surgery, the deformity has not recurred and our patient is living without any limitations in daily activities or regular exercise. When a long bone is in a prolonged state of deformation, the deformity not only progresses as the bone grows, but the soft tissues remain unbalanced and treatment becomes increasingly difficult. To prevent increasing bone deformity and fragility, the deformity should be corrected as quickly as possible using intramedullary nailing or other fixation techniques. We believe that our shortening-distraction method is effective for the treatment of severe deformity with unbalanced soft tissues.