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距骨原发性骨巨细胞瘤病灶内刮除植骨术中的内踝骨切开术。

Medial malleolar osteotomy for intralesional curettage and bone grafting of primary aneurysmal bone cyst of the talus.

机构信息

Orthopaedics, AIIMS, Bhubaneswar, Orissa, India

Orthopaedics, AIIMS, Bhubaneswar, Orissa, India.

出版信息

BMJ Case Rep. 2021 May 7;14(5):e242452. doi: 10.1136/bcr-2021-242452.

Abstract

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.

摘要

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。

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