[Diagnosis and treatment of eosinophilic granuloma of long bones in children].

OBJECTIVE

To investigate the operative procedure and the effectiveness of eosinophilic granuloma (EG) of long bones in children.

METHODS

Between January 2005 and December 2009, 14 patients with EG of long bones were treated. There were 9 boys and 5 girls, aged from 1 to 13 years (mean, 6.5 years). The locations were femur in 5 cases, humerus in 4 cases, tibia in 2 cases, fibula in 1 case, and femur complicated with tibia in 2 cases. The disease duration was 7 days to 10 months (median, 2 months). X-ray films showed that osteolytic destruction had clear boundary, which did not involve the epiphyseal plate. Of 14 cases, 12 cases of tumor were treated by curettage, autologous iliac bone or combined artificial bone graft repair, and 2 cases were treated by resection, autologous iliac reconstruction, plate and screw fixation. Five cases complicated with pathological fracture underwent reduction and fixation.

RESULTS

All cases were diagnosed pathologically as having EG. All incisions healed by first intention. A total of 12 patients were followed up 1 to 4 years (mean, 2 years). The X-ray films showed tumor focus and pathological fracture healed within 3 to 4 months (mean, 3.5 months). Tibial lesion was found in 1 case of femoral tumor after 8 months, and was cured after reoperation. No recurrence occurred in other 11 cases. According to comprehensive assessing standard of X-ray film and joint function, the results of all cases were excellent.

CONCLUSION

EG of long bones in children is more common in the femur and humerus. Tumor curettage and autologous iliac bone graft repair is an effective method, and postoperative prognosis is good. There may be multiple lesions, so long-term follow-up is needed.