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股骨近端的良性病变常削弱股骨颈的支撑结构,我院1989年6月~1995年6月用异体皮质骨支撑植骨修复股骨头颈部肿瘤性骨缺损共26例。其中骨纤维异常增殖症12例,骨孤立性骨囊肿6例,骨韧带样纤维瘤5例,骨巨细胞瘤2例,成软骨细胞瘤1例。根据肿瘤的病理诊断,病灶分别采取单纯刮除12例;刮除结合冷冻8例;在治疗6例多发或病灶范围广泛的骨纤维异常增殖症过程中,病灶未作处理。26例中,14例同时行内固定手术。所有病例术后即开始接受持续被动运动锻炼。经过12~72月(平均46月)随访,功能优秀17例、良好9例。作者认为异体皮质骨支撑植骨有增强股骨颈的强度,防止病骨疲劳骨折和畸形的作用,而内固定则促进了植骨块与受骨床的结合和使患者免受外固定之苦
The benign lesions of the proximal femur often weaken the supporting structure of the femoral neck. In our hospital from June 1989 to June 1995, a total of 26 cases of femoral head and neck tumor bone defects were repaired with allogeneic cortical bone grafts. Among them, 12 cases of osteofibrous dysplasia, 6 cases of isolated bone cysts, 5 cases of bone ligamentous fibroids, 2 cases of giant cell tumor of bone, and 1 case of chondroblastoma. According to the pathological diagnosis of the tumor, the lesions were treated with simple curettage in 12 cases, curettage in combination with freezing in 8 cases, and in the treatment of 6 cases with multiple or extensive lesions of bone fiber hyperplasia, the lesions were not treated. Of the 26 cases, 14 underwent internal fixation. All patients began to receive passive exercise after surgery. After 12-72 months (mean, 46 months) follow-up, the function was excellent in 17 cases and good in 9 cases. The authors believe that allogeneic cortical bone-supported bone grafting enhances the strength of femoral neck and prevents bone fractures and malformations, while internal fixation promotes the combination of bone graft and bone graft and protects patients from external fixation.