Eyesan S U, Idowu O K, Obalum D C, Nnodu O E, Abdulkareem F B
Department of Orthopedics and Trauma Surgery, National Orthopedic Hospital, Igbobi, Lagos, Nigeria.
Niger J Clin Pract. 2011 Apr-Jun;14(2):146-50. doi: 10.4103/1119-3077.84003.
The surgical management of symptomatic benign bone tumor has been described in various manners in medical literature. However, there are few published reports on the presentation and surgical management of benign bone tumors in black African patients.
To determine the pattern of presentation of benign bone tumors and evaluate the common indications for surgery in a Nigerian Orthopedic Center.
This is a prospective study of 67 patients, surgically treated for benign bone tumors, over a three-year period, at the National Orthopedic Hospital, Lagos, Nigeria.
The common histological types include, osteochondroma, giant cell tumor, and the simple bone cyst. These tumors have varying anatomic locations, but are more commonly located around the knee joint. In this series, most of the patients have presented with an active or aggressive stage of the disease. The most common indication for surgery is painful swelling; other indications include a pathological fracture, restricted range of movement, and peripheral nerve compression. The surgical procedures performed are simple excision, curettage, and stabilization; and 1-stage and 2-stage wide resection with reconstruction. Patients with significant bone defects have autologous bone grafting or methylmethacrylate cement application. Further stabilization is achieved with intramedullary or compression plate and screw fixation. Amputation has only been necessary in one patient with a huge aneurysmal bone cyst. At the average follow-up period of 28.6 months, five patients showed recurrence. All were with a histological diagnosis of giant cell tumor.
The mode of presentation of benign bone tumors in this group of black African patients is heterogenous, demanding various surgical options. Limb sparing is a largely feasible option, but the recurrence rate is particularly higher for giant cell tumors. Increase in the number of patients presenting with giant cell tumors raises the possibility of an increase in the incidence of this condition in the black African population. Larger multicenter studies in the black African population may shed more light on the actual incidence of giant cell tumors and other bone tumors in this group of patients.
医学文献中已以多种方式描述了有症状的良性骨肿瘤的外科治疗。然而，关于非洲黑人患者良性骨肿瘤的表现及外科治疗的已发表报告很少。
确定尼日利亚一家骨科中心良性骨肿瘤的表现模式，并评估常见的手术指征。
这是一项对67例因良性骨肿瘤接受手术治疗的患者进行的前瞻性研究，研究时间为三年，地点在尼日利亚拉各斯的国家骨科医院。
常见的组织学类型包括骨软骨瘤、骨巨细胞瘤和单纯骨囊肿。这些肿瘤有不同的解剖位置，但更常见于膝关节周围。在本系列研究中，大多数患者就诊时疾病处于活动期或侵袭期。最常见的手术指征是疼痛性肿胀；其他指征包括病理性骨折、活动范围受限和周围神经受压。所施行的手术操作包括单纯切除、刮除和稳定术；以及一期和二期广泛切除并重建。有明显骨缺损的患者采用自体骨移植或应用甲基丙烯酸甲酯骨水泥。通过髓内或加压钢板及螺钉固定实现进一步稳定。仅1例巨大动脉瘤样骨囊肿患者需要截肢。在平均28.6个月的随访期内，5例患者出现复发。所有复发患者组织学诊断均为骨巨细胞瘤。
这组非洲黑人患者中良性骨肿瘤的表现方式各异，需要多种手术选择。保肢在很大程度上是可行的选择，但骨巨细胞瘤的复发率特别高。骨巨细胞瘤患者数量的增加增加了这种疾病在非洲黑人人群中发病率上升的可能性。在非洲黑人人群中开展更大规模的多中心研究可能会更清楚地揭示这组患者中骨巨细胞瘤及其他骨肿瘤的实际发病率。
