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关节镜下切除股骨颈小转子骨样骨瘤

Arthroscopic Excision of an Osteoid Osteoma of the Lesser Trochanter of the Femoral Neck.

作者信息

Yoon Byung-Ho, Kim Jung Gon, Ha Yong-Chan

机构信息

Department of Orthopaedic Surgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Republic of Korea.

Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea.

出版信息

Arthrosc Tech. 2017 Aug 21;6(4):e1361-e1365. doi: 10.1016/j.eats.2017.05.017. eCollection 2017 Aug.

Abstract

Osteoid osteoma frequently requires surgical treatment, especially among young, active patients. However, surgeons are reluctant to perform open surgery for an osteoid osteoma of the femoral neck area because the conventional surgical approach requires a large incision in muscular patients, and percutaneous resection with a trephine has the attendant risk of subsequent fracture. Recently, arthroscopic excision of an osteoid osteoma has been reported as a less invasive, safer procedure than traditional open curettage. Hip arthroscopy using the burr-down technique under C-arm guidance to locate and remove the lesion of the femur neck has also shown promise. The presented technique minimizes muscle damage around the femur and enables surgeons to confirm complete resection of the lesion through direct, detailed visualization. Furthermore, early return to previous activity can be achieved after excising the lesion located at the calcar femorale, which is an area with a heavy weight-bearing load. The objective of this Technical Note was to describe our preferred technique for the surgical excision of osteoid osteoma located at the base of the femoral neck through the use of arthroscopy.

摘要

骨样骨瘤常常需要手术治疗,尤其是在年轻、活跃的患者中。然而,外科医生不愿对股骨颈区域的骨样骨瘤进行开放手术,因为传统手术方法对于肌肉发达的患者需要做一个大切口,而用环锯进行经皮切除会有随后发生骨折的风险。最近,有报道称骨样骨瘤的关节镜切除是一种比传统开放刮除术侵入性更小、更安全的手术。在C形臂引导下使用磨钻技术进行髋关节镜检查以定位和切除股骨颈病变也显示出前景。所介绍的技术可将股骨周围的肌肉损伤降至最低,并使外科医生能够通过直接、详细的可视化确认病变已完全切除。此外,切除位于股骨距(一个负重较大的区域)的病变后,患者可以早期恢复到之前的活动水平。本技术说明的目的是描述我们通过关节镜手术切除位于股骨颈基部的骨样骨瘤的首选技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bab/5622304/8733a09e8bc3/gr1.jpg

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