Paloski Michael D, Griesser Michael J, Jacobson Mark E, Scharschmidt Thomas J
Department of Orthopaedics, Doctors Hospital, Columbus, Ohio, USA.
Am J Orthop (Belle Mead NJ). 2011 Sep;40(9):E177-81.
Chondroblastomas usually present in the epiphyseal region of bones in skeletally immature patients. These uncommon, benign tumors are usually treated with curettage and use of a bone-void filler. Here we report a case of a hip fracture secondary to an underlying chondroblastoma in a 19-year-old woman. Open biopsy with intraoperative frozen section pointed toward a diagnosis of chondroblastoma. Extended curettage was performed, followed by cryotherapy with a liquid nitrogen gun and filling of the defect with calcium phosphate bone substitute. The femoral neck fracture was stabilized with a sliding hip screw construct. The patient progressed well and continued to regain functional status. A final pathology report confirmed the lesion to be a chondroblastoma. Clinicians should have heightened awareness of a pathologic lesion in a young person presenting with a femoral neck fracture and should consider the uncommon differential diagnosis that the lesion is located in the greater trochanter apophysis.
软骨母细胞瘤通常出现在骨骼未成熟患者的骨骺区域。这些不常见的良性肿瘤通常采用刮除术并使用骨缺损填充材料进行治疗。在此,我们报告一例19岁女性因潜在的软骨母细胞瘤继发髋部骨折的病例。术中冰冻切片的开放活检提示软骨母细胞瘤的诊断。进行了扩大刮除术,随后用液氮枪进行冷冻治疗,并用磷酸钙骨替代物填充缺损。用滑动髋螺钉结构固定股骨颈骨折。患者恢复良好,继续恢复功能状态。最终病理报告证实病变为软骨母细胞瘤。临床医生对于出现股骨颈骨折的年轻人中的病理性病变应提高警惕,并应考虑病变位于大转子骨骺这一不常见的鉴别诊断。