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关节镜下病灶内刮除术治疗大型距骨穹窿部良性囊肿

Arthroscopic intralesional curettage for large benign talar dome cysts.

作者信息

El Shazly Ossama, Abou El Soud Maged M, Nasef Abdelatif Nasef Mohamed

机构信息

Orthopedic Department of Ain Shams University 11517 Cairo Egypt.

Faculty of Medicine, Bani Suef University Teaching Hospitals 62511 Bani Suef Egypt.

出版信息

SICOT J. 2015 Dec 1;1:32. doi: 10.1051/sicotj/2015032.

Abstract

INTRODUCTION

Surgical management of large talar dome cysts is challenging due to increased morbidity by associated cartilage damage and malleolar osteotomy. The purpose of this study is to evaluate the clinical and radiological outcome of endoscopic curettage and bone graft for large talar dome cysts.

METHODS

This is a retrospective analysis of data for eight patients (eight feet) who were treated by arthroscopic curettage and grafting for large talar dome cysts. Seven cases were treated by posterior ankle arthroscopy as the lesion was located posteriorly while one case was treated by anterior ankle arthroscopy as the lesion was breached anteriorly.

RESULTS

The final diagnosis, was; large osteochondral lesion of talus (two cases), aneurysmal bone cyst (ABC) (two case), intra-osseous ganglion (two cases), Chronic infection in talus (one case) and angiomatous lesion of the talus (one case). The mean follow up period was 18.3 (±3.06 SD) months (range 16-25 months). The median preoperative AOFAS score was 74.5 (±5.34 SD) points. The mean postoperative AOFAS score at one year follow up was 94.6 (±2.97 SD) points. None of the patient had recurrence of the lesion during follow up. Return to normal daily activity was achieved at 11.25 (±2.37 SD) weeks.

DISCUSSION

In this short case series study, large talar dome bony cysts of different pathologies including aneurysmal bone cysts could be treated effectively by endoscopic curettage and bone grafting with no recurrence no complications during the follow-up period.

摘要

引言

由于相关软骨损伤和踝关节截骨导致的发病率增加,距骨穹窿大囊肿的手术治疗具有挑战性。本研究的目的是评估内镜刮除和植骨治疗距骨穹窿大囊肿的临床和影像学结果。

方法

这是一项对八名患者(八只脚)的数据进行的回顾性分析,这些患者接受了关节镜下刮除和植骨治疗距骨穹窿大囊肿。七例因病变位于后方而采用后踝关节镜治疗,一例因病变向前突破而采用前踝关节镜治疗。

结果

最终诊断为;距骨大骨软骨损伤(两例)、动脉瘤样骨囊肿(ABC)(两例)、骨内腱鞘囊肿(两例)、距骨慢性感染(一例)和距骨血管瘤样病变(一例)。平均随访期为18.3(±3.06标准差)个月(范围16 - 25个月)。术前AOFAS评分中位数为74.5(±5.34标准差)分。一年随访时术后AOFAS评分平均为94.6(±2.97标准差)分。随访期间无患者病变复发。在11.25(±2.37标准差)周时恢复正常日常活动。

讨论

在这个简短的病例系列研究中,包括动脉瘤样骨囊肿在内的不同病理类型的距骨穹窿大骨囊肿可以通过内镜刮除和植骨有效治疗,随访期间无复发且无并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c16/4849243/f11f8b8c02af/sicotj-1-32-fig1.jpg

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