Morii Takeshi, Mochizuki Kazuo, Tajima Takashi, Satomi Kazuhiko
Department of Orthopedic Surgery, Kyorin University, Tokyo, Japan.
J Orthop Sci. 2010 Jan;15(1):112-7. doi: 10.1007/s00776-009-1419-7. Epub 2010 Feb 12.
Simple curettage for enchondroma without augmentation, known to lead to spontaneous bone consolidation at the curettage site, is a potential standard treatment for this condition. However, few detailed data comparing the results of this technique with conventional methods including reconstruction are available, and the relation between the postoperative completion period for bone consolidation and preoperative independent variables is not known.
The subjects included 38 patients with enchondroma treated with simple curettage without augmentation. A historical group of patients with enchondroma treated with hydroxyapatite reconstruction was enrolled as controls. Treatment outcomes, including perioperative complications (e.g., infection, functional loss, recurrence, postoperative fracture), were surveyed. Differences in the period needed for bone formation among the patient groups defined by various preoperative patient conditions were also analyzed.
The follow-up period ranged from 12 to 60 months (average 24.3 months). During the follow-up period, no surgery-related complications occurred. Bone formation was confirmed in all cases 3-20 weeks (average 6.5 weeks) postoperatively. Tumor size represented by two-dimensional measurements was significantly correlated with the bone formation period. Polycystic lesions required a prolonged postoperative bone formation period compared with monocystic lesions. The bone formation period did not significantly differ between the simple curettage group and the historical control group.
Simple curettage without augmentation proved to be a safe, promising modality for the treatment of small enchondromas in the hand and foot.
对于内生软骨瘤，单纯刮除术不进行植骨，已知可导致刮除部位自然骨愈合，是治疗该疾病的一种潜在标准方法。然而，很少有详细数据比较该技术与包括重建在内的传统方法的结果，且骨愈合术后完成时间与术前独立变量之间的关系尚不清楚。
研究对象包括38例行单纯刮除术不进行植骨治疗的内生软骨瘤患者。选取一组接受羟基磷灰石重建治疗的内生软骨瘤患者作为历史对照组。调查治疗结果，包括围手术期并发症（如感染、功能丧失、复发、术后骨折）。还分析了根据各种术前患者情况定义的患者组之间骨形成所需时间的差异。
随访时间为12至60个月（平均24.3个月）。随访期间，未发生与手术相关的并发症。所有病例术后3 - 20周（平均6.5周）均证实有骨形成。二维测量表示的肿瘤大小与骨形成期显著相关。与单囊性病变相比，多囊性病变术后骨形成期延长。单纯刮除术组与历史对照组的骨形成期无显著差异。
单纯刮除术不进行植骨被证明是治疗手足小内生软骨瘤的一种安全、有前景的方法。
