Agarwal Anil, Qureshi Nadeem Akhtar, Kumar Pawan, Khan Shariq
Department of Orthopaedics, CNBC, Geeta Colony, Delhi, India.
Hand Surg. 2011;16(1):19-27. doi: 10.1142/S0218810411005011.
The purpose of the series is to describe the management of tubercular osteomyelitis of metacarpals and phalanges in 11 children (range, 3-12 years) and to retrospectively analyse the relationship between radiological staging and clinical outcome following treatment. The available literature on the clinical and radiological manifestations of tubercular osteomyelitis of the hand (excluding wrist) was also reviewed. Follow-up averaged 17.7 months following completion of treatment. The different radiological descriptions of the condition could be grouped into three stages: Stage 1 (stage of soft tissue swelling and no bony changes), Stage 2 (stage of bony expansion) and Stage 3 (stage of destruction). The previously described different radiological entities of tubercular osteomyelitis of metacarpals and phalanges appear to be a sequential manifestation of the disease spectrum. Healing with non-operative treatment is excellent provided the diagnosis is made when tuberculosis presents with soft tissue swelling alone and before bony destruction occurs.
本系列研究旨在描述11例儿童（年龄范围3至12岁）掌骨和指骨结核性骨髓炎的治疗情况，并回顾性分析治疗后放射学分期与临床结果之间的关系。同时，还对关于手部（不包括腕部）结核性骨髓炎的临床和放射学表现的现有文献进行了综述。治疗结束后平均随访17.7个月。该疾病不同的放射学描述可分为三个阶段：第1阶段（软组织肿胀且无骨质改变阶段）、第2阶段（骨质膨胀阶段）和第3阶段（破坏阶段）。先前描述的掌骨和指骨结核性骨髓炎不同的放射学表现似乎是疾病谱的连续表现。如果在结核病仅表现为软组织肿胀且骨质破坏尚未发生时作出诊断，非手术治疗的愈合效果极佳。
