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肘部骨母细胞瘤:13例患者分析及文献综述

Osteoblastoma of the elbow: analysis of 13 patients and literature review.

作者信息

Angelini Andrea, Varela-Osorio Andrès Felipe, Trovarelli Giulia, Berizzi Antonio, Zanotti Gabriele, Ruggieri Pietro

机构信息

Department of Orthopedics and Orthopedic Oncology, University of Padova, Via Giustiniani 3, 35128, Padua, Italy.

Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy.

出版信息

Eur J Orthop Surg Traumatol. 2017 Aug;27(6):787-795. doi: 10.1007/s00590-017-1997-6. Epub 2017 Jun 20.

Abstract

PURPOSE

To analyze the clinical and radiographic characteristics, treatment, and outcome of patients with elbow osteoblastoma.

PATIENTS AND METHODS

We present 13 patients (7 males and 6 females; mean age, 28 years) diagnosed and treated for an elbow osteoblastoma from 1975 to 2012. Mean follow-up was 29 months (range 12-60 months). Clinical presentation, imaging, surgical treatment, complications, range of elbow motion, and functional outcome were evaluated. The MSTS, DASH, and OXFORD scores were used.

RESULTS

Main symptom was pain (all patients) accompanied by stiffness (8 patients) and swelling or tumefaction (7 patients), with a median duration of symptoms of 32 months (range 6-96 months). Distal humerus was affected in 10 patients, proximal ulna in 2 patients, and proximal radius in one patient. All patients underwent surgical therapy that consisted of curettage of the lesion (7 patients), curettage and bone allografting (3 patients), wide resection (2 patients; total distal humerus and resection of the radial head), and radiofrequency thermal ablation (1 patient). One patient experienced a recurrence after surgical treatment. The mean MSTS score after treatment was 87% (range 50-100%), which corresponds to excellent results.

CONCLUSIONS

Intralesional surgery is successful in tumor control in most patients with osteoblastoma of the elbow. Thermal ablation may be successful for smaller lesions. Most of the patients had a good-to-excellent functional outcome even if they had tumor-related elbow stiffness at diagnosis.

LEVEL OF EVIDENCE

Therapeutic study, Level IV-1.

摘要

目的

分析肘部骨母细胞瘤患者的临床及影像学特征、治疗方法及预后。

患者与方法

我们报告了1975年至2012年期间诊断并治疗的13例肘部骨母细胞瘤患者(7例男性,6例女性;平均年龄28岁)。平均随访时间为29个月(范围12 - 60个月)。对临床表现、影像学检查、手术治疗、并发症、肘关节活动范围及功能预后进行了评估。采用了肌肉骨骼肿瘤学会(MSTS)、上肢功能障碍评分(DASH)及牛津评分。

结果

主要症状为疼痛(所有患者),伴有僵硬(8例患者)及肿胀(7例患者),症状中位持续时间为32个月(范围6 - 96个月)。10例患者肱骨远端受累,2例患者尺骨近端受累,1例患者桡骨近端受累。所有患者均接受了手术治疗,包括病灶刮除术(7例患者)、病灶刮除及骨移植术(3例患者)、广泛切除术(2例患者;肱骨远端全切及桡骨头切除术)及射频热消融术(1例患者)。1例患者术后复发。治疗后平均MSTS评分为87%(范围50 - 100%),对应优良结果。

结论

对于大多数肘部骨母细胞瘤患者,病灶内手术在肿瘤控制方面是成功的。热消融对于较小病灶可能成功。即使部分患者在诊断时存在与肿瘤相关的肘关节僵硬,多数患者的功能预后仍为良好至优秀。

证据水平

治疗性研究,IV - 1级。

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