Shears E, Dehne K, Murata H, Abudu A, Grimer R J, Tillman R M, Carter S R
Royal Orthopaedic Hospital, Birmingham, United Kingdom.
Foot Ankle Surg. 2008;14(3):161-5. doi: 10.1016/j.fas.2008.01.006. Epub 2008 Apr 18.
Curettage of benign tumours commonly results in significant bone defects that are reconstructed with autologous grafts, allografts, bone cement or bone substitute. We have treated such defects in the talus without reconstruction with bone or any other material. We now report the healing of these ungrafted defects in eight patients treated with curettage for benign talar tumours.
Eight consecutive patients were reviewed retrospectively at a mean follow-up of 82 months (range: 28-180 months). Mean age was 21.7 years (range: 12.3-31.3 years) and mean defect size was 16.5 cm(3) (range: 3.5-48 cm(3)). Outcome measures included time to radiological consolidation, ankle pain and stiffness, talar collapse, and tibiotalar joint osteoarthritis.
Full consolidation of the defect occurred within 6-12 months in all patients. One patient had minor discomfort over the scar, but there was no ankle joint pain. Two patients had some ankle stiffness, although one had established ankle osteoarthritis prior to surgery. No talar collapse, fracture or new significant osteoarthritis of the ankle was observed.
We conclude that bone grafting is not a necessary adjunct to the curettage of talar lesions.
刮除良性肿瘤通常会导致明显的骨缺损，需用自体骨移植、异体骨、骨水泥或骨替代物进行重建。我们在距骨处理此类缺损时未使用骨或任何其他材料进行重建。我们现在报告8例因良性距骨肿瘤接受刮除术治疗的患者中这些未植骨缺损的愈合情况。
对8例连续患者进行回顾性分析，平均随访82个月（范围：28 - 180个月）。平均年龄为21.7岁（范围：12.3 - 31.3岁），平均缺损大小为16.5 cm³（范围：3.5 - 48 cm³）。观察指标包括放射学愈合时间、踝关节疼痛和僵硬程度、距骨塌陷以及胫距关节骨关节炎。
所有患者缺损均在6 - 12个月内完全愈合。1例患者瘢痕处有轻微不适，但无踝关节疼痛。2例患者有一定程度的踝关节僵硬，尽管其中1例在手术前已存在踝关节骨关节炎。未观察到距骨塌陷、骨折或踝关节新的明显骨关节炎。
我们得出结论，骨移植并非距骨病变刮除术的必要辅助手段。
