Pearce Stephanie, Manci Elizabeth, Nimityongskul Prasit
Orthopedics. 2019 Jul 1;42(4):e391-e394. doi: 10.3928/01477447-20190624-06.
A 14-year-old boy presented with sharp left ankle pain for 1.5 years. Evaluation showed an irregular lytic lesion with surrounding sclerosis (diameter, 1.3×1.2×1.1 cm) in the central part of the distal tibial epiphysis, extending from the physis to the plafond with articular penetration. Treatment included intralesional curettage and bone grafting through a mid-anterior epiphyseal bone tunnel with fluoroscopic guidance and use of a gelatin foam sponge to help contain the bone graft within the epiphyseal cavity. Microscopic examination of the excised tissue was consistent with chondroblastoma. Ankle arthroscopy 11 months later showed that the tibial plafond articular surface was fully healed. Two years postoperatively, the patient was asymptomatic and had no recurrence. This case shows that intralesional curettage and bone grafting, with a gelatin foam sponge to prevent graft extrusion, may be used successfully in treating distal tibial epiphyseal chondroblastoma that penetrates the ankle joint. [Orthopedics. 2019; 42(4):e391-e394.].
一名14岁男孩因左踝关节剧痛就诊，症状已持续1.5年。评估显示，在胫骨远端骨骺中部有一个不规则的溶骨性病变，周围有硬化（直径1.3×1.2×1.1厘米），从骨骺板延伸至关节面并穿透关节。治疗方法包括在透视引导下，通过前侧骨骺骨隧道进行病灶内刮除和植骨，并使用明胶海绵将骨移植材料固定在骨骺腔内。对切除组织的显微镜检查结果与软骨母细胞瘤相符。11个月后的踝关节镜检查显示，胫骨关节面已完全愈合。术后两年，患者无症状，无复发。该病例表明，病灶内刮除和植骨，并用明胶海绵防止移植材料挤出，可成功用于治疗穿透踝关节的胫骨远端骨骺软骨母细胞瘤。[《骨科》。2019年；42(4):e391 - e394。]
