Aycan Osman Emre, Keskin Abdi, Sökücü Sami, Özer Devrim, Kabukçuoğlu Fevziye, Kabukçuoğlu Yavuz Selim
Orthopaedic Surgeon, Orthopaedic Oncology Clinic, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
Orthopaedic Surgeon, Orthopaedic Oncology Clinic, Baltalimanı Bone Diseases Training and Research Hospital, İstanbul, Turkey.
J Foot Ankle Surg. 2017 Nov-Dec;56(6):1205-1208. doi: 10.1053/j.jfas.2017.05.034.
Intraosseous lipoma of the calcaneus is a benign lesion formed by mature adipose tissue. When the lesion is symptomatic, the most frequent presentation is localized pain and soft tissue swelling. Because these lesions can regress spontaneously, conservative treatment methods are recommended. Operative excision is mostly required for painful lesions and pathologic fractures. The data from 14 patients with calcaneal intraosseous lipoma, who had undergone surgery in our clinic, were evaluated retrospectively. Using Milgram's classification system, 9 lesions were classified as stage 1, 4 as stage 2, and 1 as stage 3. All lesions were occupying 100% of intracalcaneal cross-section in the coronal plane and >30% in the sagittal plane of magnetic resonance imaging sections. The mean preoperative visual analog scale score was 5.29 ± 1.14 (range 4 to 7), and the mean postoperative visual analog scale score at the last follow-up visit was 1.14 ± 0.36 (range 1 to 2), which was significantly better (p < .01). The mean Maryland foot score at the last follow-up visit was 97.71 ± 2.02 (range 95 to 100). The mean American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale score was 97.86 ± 2.11 (range 94 to 100) at the last follow-up visit. The differences between the pre- and postoperative values were statistically significant (p < .01). No recurrence had been detected within a median follow-up period of 84 months. Operative management of symptomatic lesions related to intraosseous lipoma of the calcaneus provides better results compared with the preoperative state.
跟骨骨内脂肪瘤是一种由成熟脂肪组织形成的良性病变。当病变出现症状时，最常见的表现是局部疼痛和软组织肿胀。由于这些病变可自发消退，因此建议采用保守治疗方法。对于疼痛性病变和病理性骨折，大多需要进行手术切除。回顾性评估了在我们诊所接受手术的14例跟骨骨内脂肪瘤患者的数据。采用米尔格拉姆分类系统，9个病变被分类为1期，4个为2期，1个为3期。所有病变在磁共振成像切片的冠状面中占据跟骨内横截面的100%，在矢状面中占据>30%。术前视觉模拟评分量表的平均得分为5.29±1.14（范围为4至7），末次随访时术后视觉模拟评分量表的平均得分为1.14±0.36（范围为1至2），明显更好（p<.01）。末次随访时马里兰足部评分的平均得分为97.71±2.02（范围为95至100）。末次随访时美国矫形足踝协会踝-后足量表评分的平均得分为97.86±2.11（范围为94至100）。术前和术后值之间的差异具有统计学意义（p<.01）。在中位随访期84个月内未检测到复发。与术前状态相比，对跟骨骨内脂肪瘤相关的有症状病变进行手术治疗可提供更好的结果。
