Orthopaedics, AIIMS, Bhubaneswar, Orissa, India
Orthopaedics, AIIMS, Bhubaneswar, Orissa, India.
BMJ Case Rep. 2021 May 7;14(5):e242452. doi: 10.1136/bcr-2021-242452.
Access to the cystic lesion of the talar body without damage to the articular surface is difficult. This case report is about a 23-year-old man who had a symptomatic huge cystic lesion in the left-sided talus bone. Radiograph and CT scan showed an expansile lytic lesion within the talar body. The MRI revealed a well-defined lesion with fluid-fluid levels. The needle biopsy aspirate was haemorrhagic, and hence a diagnosis of the aneurysmal bone cyst was made. As the lesion was beneath the talar dome with an intact neck and head, a medial approach with medial malleolar osteotomy was performed. The lesion was curetted out, and the cavity was filled up with a morselised bone graft. The limb was splinted for 6 weeks, and complete weight bearing was started after 3 months. At 1-year follow-up, the lesion was found to be healed up, and the patient was pain-free with no recurrence.
触及距骨体的囊性病变而不损伤关节面较为困难。本病例报告介绍了一位 23 岁男性,其左侧距骨有症状性巨大囊性病变。X 线片和 CT 扫描显示距骨体内膨胀性溶骨性病变。MRI 显示界限清楚的病变,存在液-液平面。针吸活检抽吸物为血性,因此诊断为骨巨细胞瘤。由于病变位于距骨穹窿下方,距骨颈和头部完整,因此采用内侧入路联合内踝截骨术。切除病变,用骨碎块植骨填充空腔。肢体用夹板固定 6 周,3 个月后开始完全负重。1 年随访时,病变已愈合,患者无疼痛,无复发。