Trapdoor Procedure for Benign Bone Lesions in the Femoral Head of Skeletally Immature Children.

IF 1.8 2区医学 Q2 ORTHOPEDICS

Orthopaedic Surgery Pub Date : 2025-05-29 DOI:10.1111/os.70083

Qichao Ma, Fangchun Jin, Taichun Li, Honghong Pei, Yichen Wang, Yi Luo, Ziming Zhang

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引用次数: 0

Abstract

Objective: Benign bone lesions involving the femoral head are common in pediatric populations but pose significant challenges due to anatomical complexity and the need to preserve growth plate integrity. This study aims to evaluate the efficacy of the trapdoor procedure in treating these lesions in skeletally immature patients.

Methods: From 2013 to 2023, five pediatric patients with femoral head bone lesions were identified who underwent the trapdoor procedure retrospectively. Preoperative assessments included computed tomography (CT) and magnetic resonance imaging (MRI). Follow-up spanned a mean of 37.8 ± 11.2 months, with attention to pathology, recurrence, and complications. Functional outcomes were assessed using the McKay clinical grading method.

Results: Histological examination postoperatively confirmed Langerhans cell histiocytosis (LCH) in two patients and chondroblastoma in two others. One patient's diagnosis remained unclear, indicating only fibrous tissue cell proliferation. No recurrences were observed, but avascular necrosis (AVN) occurred in both LCH patients, necessitating revision surgery.

Conclusions: The trapdoor procedure is a safe and effective method for treating benign bone lesions of the femoral head in children, with attention needed for the potential of AVN.

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活板门手术治疗骨骼发育不成熟儿童股骨头良性病变。

目的：涉及股骨头的良性骨病变在儿科人群中很常见，但由于解剖复杂性和保持生长板完整性的需要，这构成了重大挑战。本研究旨在评估活板门手术治疗骨骼未成熟患者这些病变的疗效。方法：回顾性分析2013 - 2023年5例行活板门手术的儿童股骨头病变患者。术前评估包括计算机断层扫描（CT）和磁共振成像（MRI）。随访时间平均为37.8±11.2个月，关注病理、复发及并发症。功能结果采用McKay临床分级法进行评估。结果：术后组织学检查证实2例为朗格汉斯细胞组织细胞增生症（LCH）， 2例为成软骨细胞瘤。一名患者的诊断仍不明确，仅显示纤维组织细胞增生。未观察到复发，但两例LCH患者均发生了无血管坏死（AVN），需要翻修手术。结论：活板门手术是治疗儿童股骨头良性病变的一种安全有效的方法，但需注意AVN的可能性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Orthopaedic Surgery ORTHOPEDICS-

CiteScore

3.40

自引率

14.30%

发文量

374

审稿时长

20 weeks

期刊介绍： Orthopaedic Surgery (OS) is the official journal of the Chinese Orthopaedic Association, focusing on all aspects of orthopaedic technique and surgery. The journal publishes peer-reviewed articles in the following categories: Original Articles, Clinical Articles, Review Articles, Guidelines, Editorials, Commentaries, Surgical Techniques, Case Reports and Meeting Reports.