The Application Of Intramedullary Nail In The Treatment Of Fibrous Dysplasia Of Proximal Femur

BACKGROUND: With the intramedullary nail application technology perfected, thechoice of method to fix the proximal femur fractures gradually by usingintramedullary fixation in place of the steel plate outside the marrow cavity,intramedullary nailing according to specific traumatic fractures or pathologicalfracture types its design concept is further updates, witch makes the intramedullarynail using range more widely,it involves the proximal femur giant space occupyinglesion of the shaving and support areas.Tissue-engineered bone in the treatment oflarge bone defects with obvious advantages, especially when getting autogenous iliacgrafts is limited. Tissue-engineered bone can effectively fill bone defect after shavetheir lesions and other reasons, the safety and feasibility of clinical application oftissue-engineered bone has been widely confirmed. In combination with clinicalpatients who have huge benign lesions in femur rotor area, the main treatment ofusing intramedullary nail fixed has obvious advantages than traditional surgerytreatment.OBJECTIVE: To observe the short-term and medium-term curative effect by usingintramedullary nailing support in the treatment of fibrous dysplasia of proximalfemur.METHODS:A total of14patients including pathological fracture patients who hadbeen diagnosed with clear pathological diagnosis of fibrous dysplasia of proximalfemur were adopted and studied, all patients were performed intramedullary nailingsupport and tissue-engineered bone filling treatment, the indicators we collectedbefore and after surgery using SPSS17.0software for statistical analysis, we put thepreoperative and postoperative related index into a paired t test analysis, p <0.01of the difference has a significant meaning.RESULTS AND CONCLUTIONS: All of the14patients underwent more than6months of follow-up, no rejection reaction and complications occured,4-6weeksafter surgery all of the14patients removed hip spica brace, with a good hip mobility.After10-12weeks intramedullary nail fixed reviewing the original lesions or fractureX-ray, all of the patients without pathological fracture again,without internal fixationfailure, the Harris hip score system evaluation of10patients with the hip functionwere optimal,4patients suffering from the hip function activities for good.16-18weeks after internal fixation reviewed the X-rays, we discovered the intramedullarynailing support and original lesion area with good crawl bone substitute, after24-26weeks reviewed X-ray within the original scope of lesions appeared the growth ofnew bone. After1.0-1.5years patients with lesions area in rotor basically completedcrawl bone substitute, X-ray check found the original lesions trace be fuzzy.3casescompleted a2years of follow-up and removed the internal fixation,got a goodrecovery effect.Results confirmed: the method of using intramedullary nailingcombined with tissue-engineered bone of treating the femur rotor zone lesions, thechange of neck stem angle before and after operation was statistically significant (p <0.01), the recovery of the sick limb shortening was statistically significant (p <0.01).,The Harris hip score had no statistical significance（p=0.168＞0.01） beforeand after operation for subjects without pathological fracture. Intramedullary nailfixation stability, at the same time reduced the resection of autogenous iliac, themedium-term follow-up observed that patients recovered well after fixed.