Department of Orthopedics, West China Hospital, Sichuan University, No 37 Guo Xue Lane, Wuhou District, 610041, Chengdu, Sichuan, People's Republic of China.
World J Surg Oncol. 2018 Jan 23;16(1):14. doi: 10.1186/s12957-018-1314-9.
Chondroblastoma is a rare benign cartilaginous tumor, which primarily occurs in children and adolescents. Chondroblastoma commonly originates in the epiphyseal plate of long bones. An aggressive curettage treatment is recommended to manage lesion, which may jeopardize an open epiphyseal plate and result in limb shortening and deformity as the limb grows and develops. The purpose is to observe surgical effects of chondroblastoma on open epiphyseal plate of long bones in children and adolescents and explore influences on limb growth and development.
We retrospectively reviewed 18 cases of long bone chondroblastoma with open epiphyseal growth plate during March 2004 to October 2010 in our center. Seven females and 11 males with mean age of 11.6 ± 2.0 years old (8-15 years) were included. Patients, who suffered from trauma and pathological fracture of the epiphyseal plate or congenital diseases such as poliomyelitis, congenital dementia, and cartilage malnutrition, were excluded. All patients were treated with meticulous intralesional curettage and inactivity with alcohol followed by bone grafts. All cases were followed up 8.2 ± 1.7 years (5-11.5 years).
All had no local recurrence and distance metastasis. The length of the affected limb was short, 18.47 ± 7.22 mm (1.5-30 mm). There was no obvious relativity with tumor activity (P = 0.061). Meanwhile, there were obvious relativity with the greatest dimension of the lesion (TGD) (P = 0.003), the vertical dimension between edge of lesion and epiphyseal line (TVD) (P = 0.010), and area ratio of lesion to local epiphysis (lesion/growth plate) (P = 0.015). The MSTS93 (Revised Musculoskeletal Tumor Society Rating Scale 93) and SF-36 (Medical Outcomes Study 36-Item Short-Form Health Survey) had been significantly improved (P < 0.01).
Managing of chondroblastoma located in open epiphyseal plate of a long bone with meticulous curettage, inactivity, and bone grafts can control tumor progression and recurrence effectively. Meanwhile, early detection and prompt surgical treatment intervention, which reduced significantly the tumor to influence limb growth and development, get encouraging limb function.
This is a retrospective study, which was not registered in any trial registry.
成软骨细胞瘤是一种罕见的良性软骨肿瘤，主要发生在儿童和青少年。成软骨细胞瘤通常起源于长骨的骺板。推荐采用积极的刮除治疗来处理病变，因为这可能会危及开放的骺板，导致肢体在生长和发育过程中缩短和畸形。目的是观察成软骨细胞瘤对儿童和青少年长骨开放骺板的手术效果，并探讨其对肢体生长发育的影响。
我们回顾性分析了 2004 年 3 月至 2010 年 10 月在我院治疗的 18 例长骨成软骨细胞瘤合并开放骺板生长的患者。其中女性 7 例，男性 11 例，平均年龄 11.6±2.0 岁（8-15 岁）。排除了骺板创伤和病理性骨折以及脊髓灰质炎、先天性痴呆、软骨营养不良等先天性疾病的患者。所有患者均采用精细的病灶内刮除和酒精灭活，随后进行植骨治疗。所有病例均随访 8.2±1.7 年（5-11.5 年）。
所有患者均无局部复发和远处转移。受影响肢体的长度较短，为 18.47±7.22mm（1.5-30mm）。与肿瘤活动度无明显相关性（P=0.061）。同时，与病变的最大直径（TGD）（P=0.003）、病变边缘与骺线之间的垂直距离（TVD）（P=0.010）和病变与局部骺板的面积比（病变/生长板）（P=0.015）有明显相关性。MSTS93（改良肌肉骨骼肿瘤学会评分 93）和 SF-36（医疗结局研究 36 项简短健康调查）评分均显著提高（P<0.01）。
采用精细刮除、灭活和植骨治疗长骨开放骺板的成软骨细胞瘤，能有效控制肿瘤的进展和复发。同时，早期发现和及时手术治疗干预，显著减少了肿瘤对肢体生长发育的影响，获得了令人鼓舞的肢体功能。
这是一项回顾性研究，未在任何试验注册中心注册。
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