Lui Tun Hing
Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, China.
Arthrosc Tech. 2016 May 16;5(3):e489-93. doi: 10.1016/j.eats.2016.01.025. eCollection 2016 Jun.
Bursal chondromatosis is synovial chondromatosis of the bursae. It is a rare disease entity that can involve the adventitial bursa of the lateral ankle. Complete synovectomy, removal of loose bodies, and bursectomy comprise the treatment of choice. Detailed preoperative radiologic assessment and surgical planning are the keys to success. Any accompanying synovial chondromatosis of the ankle or subtalar joint or tenosynovial chondromatosis of the peroneal tendon sheath should be treated together with the bursectomy. Endoscopic bursectomy can be performed through the bursal portal. The proximal and distal peroneal tendoscopy portals serve as viewing portals. The resection of the diseased tissues should be performed in a step-by-step zonal manner. Complete synovectomy and removal of loose bodies should be performed before bursectomy. Internal drainage of the bursal sac into the peroneal tendon sheath may be indicated if the sac is adherent to the skin. It should only be performed after complete synovectomy and removal of loose bodies.
滑囊软骨瘤病是滑囊的滑膜软骨瘤病。它是一种罕见的疾病实体,可累及外侧踝关节的外膜滑囊。彻底的滑膜切除术、清除游离体和滑囊切除术是首选的治疗方法。详细的术前影像学评估和手术规划是成功的关键。踝关节或距下关节伴发的任何滑膜软骨瘤病或腓骨肌腱鞘的腱鞘炎应与滑囊切除术一起治疗。内镜下滑囊切除术可通过滑囊入口进行。腓骨肌腱近端和远端的关节镜入口用作观察入口。病变组织的切除应按区域逐步进行。在滑囊切除术前应进行彻底的滑膜切除术并清除游离体。如果滑囊与皮肤粘连,可能需要将滑囊囊内引流至腓骨肌腱鞘。这只能在彻底的滑膜切除术和清除游离体之后进行。