Tse W L, Hung L K, Law Bonita, Ho P C
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
J Hand Surg Am. 2003 Jul;28(4):699-703. doi: 10.1016/s0363-5023(03)00184-9.
Osteoid osteoma is a benign bone tumor that can be removed by marginal excision. Excessive removal of reactive bone may result in significant morbidity. We made use of the highly specific radioactive technetium uptake characteristic of osteoid osteoma for its localization. Radioactive technetium (25 mCi) was injected intravenously 2 hours before surgery to a 21-year-old male patient with an osteoid osteoma over the left distal radius. Tumor tissue was localized intraoperatively by a portable hand-held radioactive gamma counter to detect a focal high intensity of radioactivity. Complete tumor removal was shown by reduction of radioactivity to background level. This was confirmed by bone scintigraphy of the specimen and the forearm immediately after surgery. The defect was packed with cancellous bone graft taken from the ipsilateral distal radius through the same wound. Postoperative recovery was very satisfactory. We found this approach useful in limiting resection margin and surgical site morbidity in resection of osteoid osteoma.
骨样骨瘤是一种良性骨肿瘤，可通过边缘切除进行切除。过度切除反应性骨可能会导致严重的并发症。我们利用骨样骨瘤高度特异性的放射性锝摄取特性对其进行定位。在手术前2小时，对一名21岁左侧桡骨远端患有骨样骨瘤的男性患者静脉注射放射性锝（25毫居里）。术中通过便携式手持式放射性γ计数器定位肿瘤组织，以检测局部高强度放射性。放射性降至背景水平表明肿瘤已完全切除。术后立即对标本和前臂进行骨闪烁显像证实了这一点。通过同一伤口取自同侧桡骨远端的松质骨移植填充骨缺损。术后恢复非常令人满意。我们发现这种方法有助于在骨样骨瘤切除术中限制切除边缘和手术部位的并发症。
