Department of Orthopaedic Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania.
Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JBJS Case Connect. 2021 Feb 11;11(1):e20.00194. doi: 10.2106/JBJS.CC.20.00194.
Three female children (11-15 years) presented with painful dorsomedial medial cuneiform masses that did not improve after conservative treatment. Findings were consistent with a diagnosis of medial cuneiform apophysis. After surgical resection, no patients had recurrence, although one continued to have pain from a deep peroneal nerve sensory branch that was resected. One patient had an intramass physis identified.
When surgically removing dorsomedial cuneiform masses, surgeons should decompress overlying sensory nerve branches, detach and subsequently repair muscular attachments, and remove the entire stump to prevent regrowth because some of these masses may be apophyses and not exostoses.
三位女性儿童（11-15 岁）出现疼痛的背内侧楔骨内侧肿块，经保守治疗后未见改善。检查结果符合楔骨内侧突的诊断。手术后，所有患者均无复发，但有 1 例因同时切除了感觉支的腓深神经而持续疼痛。1 例患者发现骨内存在骨骺。
当手术切除背侧内侧楔骨肿块时，外科医生应减压上方感觉神经分支，分离并随后修复肌肉附着点，并切除整个残端，以防止复发，因为这些肿块中的一些可能是骨骺而不是骨赘。
