title: Intramedullary Nailing Combined with Bone Grafting for Benign Lesions of the Proximal Femur.
abstract: OBJECTIVE
  To evaluate the effectiveness of intramedullary nailing for benign lesions of the proximal femur.
  
  
  METHODS
  A retrospective analysis was carried out on 68 cases of benign lesions in the proximal femur at our hospital from April 2002 to April 2013 (38 men and 30 women). Mean age at surgery was 35.5 years (range, 22-56 years). The cases were divided into two groups: curettage of the lesion with bone grafting only as the grafting group (32 cases) and internal fixation after removal of the lesion as the fixation group (36 cases). For the grafting group, lesions were scraped out, deactivated and washed thoroughly with normal saline, then the allogeneic bone was implanted. For the fixation group, after the lesions were scraped, the intramedullary nails were implanted, and allogeneic bone was implanted into the scraped cavity with compaction.
  
  
  RESULTS
  Pathological examination showed that 24 out of 68 cases (35.3%) had simple bone cysts (suffered from pathological fracture in 2 cases); 21 (30.9%) fibrous dysplasia; 18 (26.5%) aneurysmal bone cysts; 3 (4.4%) chondroblastoma, 2 (2.9%) out of which were combined with aneurysmal bone cysts. All patients were followed up for 12-96 months (56 months for mean). In the grafting group, 4 patients had postoperative complications (1 pathological bone fractures and 3 deep vein thrombosis), but only 1 patient of the fixation group (deep vein thrombosis) (P < 0.05). The average bedridden time after surgery was 11.4 ± 7.6 days for the grafting group, and for the other group was 7.5 ± 5.4 days ( P < 0.05).
  
  
  CONCLUSIONS
  Both treatments are effective for benign lesions in the proximal femur, but the fixation group facilitated the functional recovery of patients and reduced postoperative complications.
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Jia-Zhen
authors.initials: JZ
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Xin-Chang
authors.initials: XC
authors.lastname: Lu
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Orthopaedics Hospital of Zhengzhou, Zhengzhou, China.
authors.forename: Huai-Shuan
authors.initials: HS
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Orthopaedics Hospital of Zhengzhou, Zhengzhou, China.
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: Shi
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Lei
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Guang
authors.initials: G
authors.lastname: Feng
authors.affiliation: Department of Orthopaedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Fu
mesh_terms: D000328:Adult; D001845:Bone Cysts / Q000000981:diagnostic imaging / Q000601:surgery; D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D003475:Curettage / Q000379:methods; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Benign bone lesion; Bone grafting; Femur; Intramedullary nailing