Mishra Pankaj Kumar, Agarwal Yash, Singhal Prakhar, Mishra Kripa Shankar
Department of Orthopaedics, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
J Orthop Case Rep. 2017 Sep-Oct;7(5):20-23. doi: 10.13107/jocr.2250-0685.880.
In the customary wisdom, it is conceded that giant-cell tumor (GCT) is a pathology of fused epiphysis, but there are literatures available to depict that even though rare bit, but it occurs in the skeletally immature patients. Here, we are presenting a rare case of GCT of the fifth metacarpal in the skeletally immature patient.
It is a case report of a 13-year-old girl with the history of swelling over her right hand for 5 months. X-ray revealed that there was an osteolytic fusiform expansible lesion. The biopsy sent and it conferred the diagnosis of GCT. Dorsal approach used for the enbloc resection of the fifth metacarpals (except at the base) and partial excision of the surrounding muscles done. The capsule and collateral ligament of the fifth metacarpophalangeal joint were left. The fourth metatarsal was harvested from the foot along with its capsule and collateral ligament of the metatarsophalangeal joint and sutured to the counter capsuloligamentous structure at the recipient site.
In our case, we are presenting the GCT of metacarpal in a skeletally immature patient, which was managed by osteoarticular graft. Management by autologous metatarsal graft is a nontraditional approach. We bring it to the horizon of knowledge to discuss the clinical and radiological presentation with surgical as well as functional outcome.
按照传统观点,人们承认骨巨细胞瘤(GCT)是一种骨骺融合的病变,但有文献表明,尽管极为罕见,但它也会发生在骨骼未成熟的患者身上。在此,我们报告一例骨骼未成熟患者的第五掌骨骨巨细胞瘤罕见病例。
这是一例13岁女孩的病例报告,其右手肿胀已有5个月病史。X线显示有一个溶骨性梭形膨胀性病变。送检活检确诊为骨巨细胞瘤。采用背侧入路对第五掌骨(除基部外)进行整块切除,并对周围肌肉进行部分切除。保留第五掌指关节的关节囊和侧副韧带。从足部获取第四跖骨及其跖趾关节的关节囊和侧副韧带,并缝合至受区的对侧关节囊韧带结构。
在我们的病例中,我们报告了一例骨骼未成熟患者的掌骨骨巨细胞瘤,采用骨关节移植进行治疗。自体跖骨移植治疗是一种非传统方法。我们将其呈现出来,以便讨论其临床和放射学表现以及手术和功能结果。