Goto Takahiro, Kawano Hirotaka, Yamamoto Aiichiro, Yokokura Satoshi, Iijima Takuo, Motoi Toru, Nakamura Kozo
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655 Tokyo, Japan.
Arch Orthop Trauma Surg. 2004 Jun;124(5):301-5. doi: 10.1007/s00402-003-0623-8. Epub 2004 Mar 11.
Simple curettage without bone grafting for enchondromas of the hand and its good clinical results have been reported. Yet, there have been no reports regarding simple curettage without bone grafting for enchondromas of the foot. The purpose of this study is to elucidate the clinical results of this method for enchondromas of the foot.
We studied eight patients (ten bones) with enchondromas of the foot treated with simple curettage without bone grafting. After making an oval or round fenestration, the enchondroma was curetted. The cortical window of the fenestration was excised in five bones, whereas it was replaced at the fenestration site in the other five bones.
The affected toe was immobilized with a tape in two patients. All patients began to walk on the day of surgery or the next day without crutches. Sclerotic changes on the plain radiographs were seen 6.4 weeks (range: 4-10 weeks) postoperatively. The patients returned to their normal daily activity including occupation and sport in 8.6 weeks (range: 0-12 weeks) postoperatively. The radiographic appearance was almost normalized in 8.4 months on average (range: 3-14 months). Function was classified as excellent in all bones according to a modified Tordai classification.
We conclude that simple curettage without bone grafting can be one of the standard surgical treatments for enchondromas of the foot.
已有报道称,手部内生软骨瘤采用单纯刮除术且不进行植骨可取得良好的临床效果。然而,关于足部内生软骨瘤采用单纯刮除术且不进行植骨的报道尚无。本研究的目的是阐明该方法治疗足部内生软骨瘤的临床效果。
我们研究了8例(10块骨)足部内生软骨瘤患者,采用单纯刮除术且不进行植骨治疗。制作椭圆形或圆形开窗后,刮除内生软骨瘤。5块骨切除开窗的皮质骨窗,而另外5块骨在开窗部位进行复位。
2例患者用胶带固定患趾。所有患者在手术当天或次日即可开始行走,无需使用拐杖。术后6.4周(范围:4 - 10周)在X线平片上可见硬化改变。患者在术后8.6周(范围:0 - 12周)恢复包括职业和运动在内的正常日常活动。平均8.4个月(范围:3 - 14个月)时影像学表现几乎恢复正常。根据改良的托尔代分类法,所有骨的功能均评定为优。
我们得出结论,单纯刮除术且不进行植骨可作为足部内生软骨瘤的标准手术治疗方法之一。