Weber K L, Morrey B F
Mayo Clinic, Rochester, Minnesota 55905, USA.
J Bone Joint Surg Am. 1999 Aug;81(8):1111-9. doi: 10.2106/00004623-199908000-00006.
Osteoid osteoma is a painful benign neoplasm that is rarely found in the elbow region.
The study included fourteen patients, and we believe that this is the largest reported series of patients with osteoid osteoma of the elbow evaluated at one institution. Most of the patients had had symptoms for a prolonged period and had had multiple invasive procedures before an accurate diagnosis was made. Although findings on physical examination generally are nonspecific and are not always accurate in localizing the lesion, plain tomograms and computed tomography scans were most helpful in identifying the nidus in the present study. Thirteen of the patients had limited motion of the elbow before the definitive diagnosis was made, and ten of these thirteen had a mean flexion contracture of 38 degrees.
Removal of the nidus resulted in relief of pain and improvement in the range of motion of the elbow in all fourteen patients. A persistent postoperative flexion contracture was more common in the patients who had had a previous arthrotomy of the elbow than in those who had not had that procedure.
It is important to recognize this uncommon entity to avoid the morbidity associated with a prolonged delay in diagnosis. Because the symptoms resolve after excision of the lesion, the surgeon can avoid unnecessary soft-tissue dissection and release of the contracture.
骨样骨瘤是一种引起疼痛的良性肿瘤，很少见于肘部区域。
本研究纳入了14例患者，我们认为这是在同一机构评估的关于肘部骨样骨瘤患者的最大报告系列。大多数患者症状持续时间较长，在准确诊断之前已接受过多次侵入性检查。尽管体格检查结果通常不具有特异性，且在定位病变时并不总是准确，但在本研究中，平片体层摄影和计算机断层扫描对识别瘤巢最有帮助。13例患者在确诊前肘部活动受限，其中10例平均屈曲挛缩38度。
切除瘤巢后，所有14例患者的疼痛均得到缓解，肘部活动范围得到改善。与未接受过肘部关节切开术的患者相比，既往接受过肘部关节切开术的患者术后持续性屈曲挛缩更为常见。
认识到这种罕见的疾病很重要，以避免因诊断长期延迟而带来的发病率。由于病变切除后症状会缓解，外科医生可以避免不必要的软组织解剖和挛缩松解。
