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足踝骨样骨瘤

Foot and Ankle Osteoid Osteomas.

作者信息

Gurkan Volkan, Erdogan Ozgur

机构信息

Assistant Professor, Bezmialem Faculty of Medicine, Istanbul, Turkey.

Orthopedist, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey.

出版信息

J Foot Ankle Surg. 2018 Jul-Aug;57(4):826-832. doi: 10.1053/j.jfas.2017.11.019. Epub 2018 Mar 2.

Abstract

Foot and ankle osteoid osteomas (OOs) are often cancellous or subperiosteal and rarely present with a periosteal reaction. Additionally, the large number of disorders included in the differential diagnosis and the nonspecific findings on radiographs complicate the diagnosis. We performed a manual search of the senior surgeon's hospitals' operating room records for the terms "benign bone tumor," "foot," "ankle," and "osteoid osteoma" from January 2003 until December 2014. Of 87 surgically treated patients with lower extremity OOs, 9 patients (11%) with foot or ankle OOs were included. The mean age at presentation was 21 (range 6 to 30) years; all 9 (11%) patients were male. The patients were evaluated for swelling, pain, trauma history, night pain, response to pain relievers, duration of complaints, and interval to diagnosis. The mean follow-up period was 48 ± 24 months, and no recurrences had developed. The mean American Orthopaedic Foot and Ankle Society scale score was 59.04 ± 11 before surgery and 91.56 ± 6 after surgery. The difference was statistically significant at p ≤ .0003. Most previous studies have been limited to case reports. The need for findings from a case series was an essential determinant of our decision to report our results. Patients usually have been treated conservatively, often for a long period. However, delays in treatment cause social, economic, and psychological damage. In conclusion, the presence of atypical findings on radiographs has resulted in a preference for magnetic resonance imaging instead of computed tomography; however, the diffuse soft tissue edema observed on MRI can lead to the use of long-term immobilization and a delay in the diagnosis.

摘要

足踝部骨样骨瘤(OOs)多为松质骨或骨膜下型,很少出现骨膜反应。此外,鉴别诊断中包含的大量疾病以及X线片上的非特异性表现使诊断变得复杂。我们手动检索了2003年1月至2014年12月期间高级外科医生所在医院手术室记录中关于“良性骨肿瘤”“足”“踝”和“骨样骨瘤”的内容。在87例接受手术治疗的下肢骨样骨瘤患者中,9例(11%)为足踝部骨样骨瘤患者。就诊时的平均年龄为21岁(范围6至30岁);所有9例(11%)患者均为男性。对患者进行了肿胀、疼痛、创伤史、夜间疼痛、对止痛药的反应、症状持续时间以及诊断间隔等方面的评估。平均随访期为48±24个月,无复发情况。美国矫形足踝协会量表术前平均评分为59.04±11,术后为91.56±6。差异具有统计学意义,p≤0.0003。以往大多数研究仅限于病例报告。我们决定报告结果的一个重要决定因素是需要病例系列研究的结果。患者通常接受保守治疗,且往往时间较长。然而,治疗延迟会造成社会、经济和心理损害。总之,X线片上的非典型表现导致人们更倾向于使用磁共振成像而非计算机断层扫描;然而,磁共振成像上观察到的弥漫性软组织水肿可能导致长期固定并延误诊断。

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