2024年 · 第104卷第43期

A 43-year-old female was admitted with "left calf pain for 1 year". The patient reported that he had left calf pain without obvious trigger 1 year ago, and had no numbness and discomfort in his limbs. He has not been diagnosed and treated, and now he feels that the pain symptoms have aggravated. Past physical health, no history of other trauma or disease. On physical examination, there was no obvious skin damage to the left calf, local skin and soft tissue swelling and tenderness, no abnormal movement of the joints of the left lower limb, and no abnormal blood supply to the skin at the extremities of the extremities. X-ray examination showed ground glass changes and cystic lesions in the middle of the left tibia, thinning of the cortex, no periosteal reaction, and osteosclerosis at the edges (Figures 1 and 2). According to the medical history, physical examination and imaging examination, the patient was initially diagnosed as benign space-occupying lesion of the left tibia, considering the possibility of bone fibrous dysplasia. Puncture pathological biopsy showed abnormal hyperplasia of bone fibrous tissue, which was consistent with the diagnosis of bone fibrous dysplasia. The domestic incidence rate of bone fibrous dysplasia is 10~30/1 million, accounting for the first of bone tumor-like lesions, and the single bone type is the most common, more common in femur and tibia, accounting for about 75% ~80% of bone fibrous dysplasia. The onset of the disease is more common in children and adolescents, and it is usually not easy to become malignant. The patient was treated by surgery. The surgical plan included curettage of the lesion, autologous iliac bone combined with allogeneic bone compression and bone grafting, and plate and screw internal fixation. On the second day after surgery, the joint flexion and extension exercise of the affected limb began without weight bearing, the partial weight bearing exercise with crutches began one month after surgery, and the full weight bearing exercise began three months after surgery, and the pain symptoms were significantly alleviated. At 1 year follow-up, the patient had no obvious pain symptoms and limited lower limb function, and the treatment results were satisfactory.