Kamal Achmad Fauzi, Simorangkir Damiarta, Oesman Ihsan
Department of Orthopaedic and Traumatology Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Ann Med Surg (Lond). 2018 Sep 20;35:33-37. doi: 10.1016/j.amsu.2018.09.017. eCollection 2018 Nov.
In most cases, osteosarcoma occurs in the metaphysis of long bones such as femur, tibia, or humerus. Meanwhile, osteosarcoma of the talus is extremely rare.
We presented a case of a thirty-eight-year-old male patient with osteosarcoma of the talus treatedwith limb salvage surgery. That procedure consists of wide excision as extra-articular resection" totaltalectomy" followed by challenging reconstruction of the defect using fibular graft and followed by internal fixation and arthrodesis. We did an extraarticular resection of the talus, which consists of total talectomy and excision of the distal tibia and fibula. An ipsilateralnon vascularized fibular graft as harvested and placed in a horizontal plane to bridge the distal tibia and fibula to the navicular. The graft was fixated using 7.5mm cannulated headless screw and was followed by arthrodesis across the distal tibia and fibula to the calcaneus.
Options for surgical treatment for osteosarcoma of the talus islimb salvage surgery. Extraarticular resection "total talectomy" and reconstruction using fibular bone grafttechnique creates a good functional outcome and no signs of local recurrence were found during one-yearfollow-up.
Extraarticular resection and reconstruction using fibular bone graftis a good technique for management of osteosarcoma of the talus.
在大多数情况下，骨肉瘤发生于股骨、胫骨或肱骨等长骨的干骺端。同时，距骨骨肉瘤极为罕见。
我们报告了一例38岁男性距骨骨肉瘤患者，接受了保肢手术治疗。该手术包括广泛切除，即关节外切除（“全距骨切除术”），随后使用腓骨移植对缺损进行具有挑战性的重建，然后进行内固定和关节融合术。我们对距骨进行了关节外切除，包括全距骨切除术以及胫骨远端和腓骨的切除。切取同侧非带血管蒂腓骨移植并置于水平位，以连接胫骨远端、腓骨与舟骨。移植骨用7.5毫米空心无头螺钉固定，随后进行跨越胫骨远端、腓骨至跟骨的关节融合术。
距骨骨肉瘤的手术治疗选择是保肢手术。关节外切除（“全距骨切除术”）及使用腓骨移植技术进行重建可取得良好的功能结果，在一年的随访期间未发现局部复发迹象。
关节外切除及使用腓骨移植进行重建是治疗距骨骨肉瘤的一种良好技术。
