弹性髓内钉联合骨替代物治疗儿童股骨近端单纯性骨囊肿的疗效

徐涛涛; 李论; 吕敏捷; 李训礼

doi:10.14188/j.1671-8852.2024.0223

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弹性髓内钉联合骨替代物治疗儿童股骨近端单纯性骨囊肿的疗效

临床医学研究 | 更新时间：2026-11-06

- 弹性髓内钉联合骨替代物治疗儿童股骨近端单纯性骨囊肿的疗效
- Efficacy of elastic stable intramedullary nail combined with bone substitutes in the treatment of simple bone cysts in children's proximal femurs
- 武汉大学学报（医学版） 2025年46卷第12期页码：1627-1633
- 作者机构：
  
  1.昆明市儿童医院骨科云南昆明 650000
  2.昆明医科大学附属儿童医院骨科云南昆明 650000
- 作者简介：
  
  徐涛涛，男，1987—，医学硕士，主治医师，主要从事儿童四肢骨与软组织肿瘤的诊治研究，E⁃mail：tao2431@163.com
  李训礼，男，1988—，医学硕士，主治医师，主要从事儿童先天性手部及足部畸形的矫正研究，E⁃mail：292635055@qq.com
- 基金信息：
  
  昆明市卫生健康委员会卫生科研课题项目(2022⁃06⁃02⁃001)
- DOI：10.14188/j.1671-8852.2024.0223
  中图分类号： R726.8
- 收稿：2024-03-31，
  
  纸质出版：2025-12-25
- 稿件说明：
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徐涛涛,李论,吕敏捷等.弹性髓内钉联合骨替代物治疗儿童股骨近端单纯性骨囊肿的疗效[J].武汉大学学报（医学版）,2025,46(12):1627-1633.

XU Taotao,LI Lun,LYU Minjie,et al.Efficacy of elastic stable intramedullary nail combined with bone substitutes in the treatment of simple bone cysts in children's proximal femurs[J].Medical Journal of Wuhan University,2025,46(12):1627-1633.
徐涛涛,李论,吕敏捷等.弹性髓内钉联合骨替代物治疗儿童股骨近端单纯性骨囊肿的疗效[J].武汉大学学报（医学版）,2025,46(12):1627-1633. DOI： 10.14188/j.1671-8852.2024.0223.

XU Taotao,LI Lun,LYU Minjie,et al.Efficacy of elastic stable intramedullary nail combined with bone substitutes in the treatment of simple bone cysts in children's proximal femurs[J].Medical Journal of Wuhan University,2025,46(12):1627-1633. DOI： 10.14188/j.1671-8852.2024.0223.

摘要

目的

探索分析弹性髓内钉（ESIN）联合骨替代物治疗儿童股骨近端单纯性骨囊肿（SBC）的疗效。

方法

回顾分析2016年1月—2023年7月昆明市儿童医院收治的股骨近端SBC患儿37例的临床资料，其中25例患者使用ESIN治疗，12例使用ESIN联合骨替代物治疗。术前及术中收集患儿性别、年龄、囊肿性质、囊肿指数、病理性骨折、弹性针数量、手术时间等资料。术后定期随访X线，采用Neer骨囊肿评价标准分析两组病例的愈合情况，采用肌肉骨骼肿瘤学会(MSTS)评分系统评价两组病例的术后功能。

结果

37例患儿均得到随访，随访时间16~87个月，平均40个月，两组间性别、年龄、骨折、囊肿指数、囊肿性质、病理性骨折、弹性针数量、手术时间及出血量差异均无统计学意义（

0.05）；术后肢体功能MSTS评分无差异（

0.05），功能均满意，无跛行、疼痛等；ESIN联合骨替代物组，完全愈合率为92%，部分愈合8%，有效率100%；ESIN组完全愈合60%，部分愈合28%，复发12%，有效率88%。ESIN联合骨替代物组在愈合等级方面优于ESIN组（

0.05），但两组治疗有效率方面无差异（

0.05）；均未出现股骨头坏死、再骨折、骨骺早闭等并发症。

结论

儿童股骨近端单纯性骨囊肿使用ESIN联合骨替代物治疗，能够取得较为满意的治疗效果，且术后复发率较低，安全性高，值得推广。

Abstract

Objective

To explore and analyze the effectiveness of elastic stable intramedullary nails (ESIN) combined with bone substitutes in the treatment of simple bone cysts (SBC) of the proximal femur in children.

Methods

The clinical data of 37 children with SBCs of the proximal femur admitted to Kunming Children's Hospital from January 2016 to July 2023 were retrospectively analyzed. Among them

25 patients were treated with ESIN

and 12 patients were treated with ESIN combined with bone substitutes. Data on gender

age

cyst nature

cyst index

pathological fracture

number of ESINs

and operative time were collected before and during surgery. After surgery

regular follow⁃up X⁃rays were obtained. Healing was assessed using the Neer bone cyst evaluation criteria

and postoperative function was evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system in both groups.

Results

All 37 patients were followed up for 16 to 87 months

with an average of 40 months. There was no significant difference in gender

age

cyst index

cyst nature

pathological fracture

number of ESINs

operative time

and blood loss between the two groups (

0.05). Postoperatively

there was no significant difference in MSTS scores for limb function (

0.05)

and functional outcomes were satisfactory

without claudication or pain. In the ESIN combined with bone substitutes group

the complete healing rate was 92%

the partial healing rate was 8%

and the effective rate was 100%. In the ESIN group

the complete healing rate was 60%

the partial healing rate was 28%

the recurrence rate was 12%

and the effective rate was 88%. ESIN combined with bone substitutes was superior to ESIN alone in terms of healing grade (

0.05)

but there was no difference in the effective rate between the two groups (

0.05). No complications such as femoral head necrosis

refracture

or premature epiphyseal closure occurred.

Conclusion

The combination of elastic stable intramedullary nails and bone substitutes in treating simple bone cysts of the proximal femur in children achieves satisfactory therapeutic effects with a low recurrence rate and high safety profile

warranting clinical application.

关键词

Keywords

references

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