Orthopedics, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
Z Orthop Unfall. 2024 Apr;162(2):143-148. doi: 10.1055/a-1938-8449. Epub 2022 Oct 20.
To investigate the diagnosis and treatment of intraosseous ganglion cyst in the ankle region.
A retrospective analysis was performed on the diagnosis and treatment of 18 patients with intraosseous ganglion in the ankle region from January 2005 to March 2016. There were 11 males and 7 females, with an average age of 40.4 years (22-74 years). Thirteen of these had mild intermittent localized pain in the ankle and five were asymptomatic and fortuitously found on images. According to the location of the intraosseous ganglion cyst, nine were located in the distal end of tibia, seven were in the distal end of the fibula, and two were in the talus. After curettage of intraosseous ganglion, 15 cases were filled with autogenous iliac bone and 3 cases with artificial bone.
Fifteen cases were diagnosed with radiographs and CT scans, two cases with MR images, and one case was confirmed by postoperative pathology. The cyst contents were jelly-like material with sclerotic bone margins. The mean size of the intraosseous ganglion cyst was 1.5 cm × 1.5 cm × 1 cm. Hematoxylin and eosin (H&E) staining of the tissue showed fibrous tissue, collagenous fiber, mucoid, and a few fibroblasts. Eighteen cases were followed up for 11 months to 10 years, with an average of 5.4 years. No recurrence was found. Sixteen patients were asymptomatic after surgery. Two cases of ankle pain occurred at 1 year and 6 months postoperatively, respectively. According to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, the mean AOFAS ankle-hindfoot score improved from 78.2 ± 13.7 points preoperatively to 97.3 ± 4.5 points at the final follow-up.
For the intraosseous ganglion cyst in the ankle region, whether there are clinical symptoms or not, the cyst should be curettaged and the cavity should be filled with bone graft. The operation result is satisfactory.
探讨踝部骨内腱鞘囊肿的诊治方法。
回顾性分析 2005 年 1 月至 2016 年 3 月收治的 18 例踝部骨内腱鞘囊肿患者的临床资料，男 11 例，女 7 例；年龄 22~74 岁，平均 40.4 岁。13 例患者踝部有轻度间歇性局部疼痛，5 例无明显症状，为偶然影像学检查发现。根据骨内腱鞘囊肿的位置，胫骨远端 9 例，腓骨远端 7 例，距骨 2 例。骨内腱鞘囊肿刮除后，15 例行自体髂骨填充，3 例行人工骨填充。
15 例患者术前 X 线片及 CT 检查诊断，2 例行 MRI 检查诊断，1 例术后病理证实。囊肿内容物为胶冻样物质，边缘骨质硬化。骨内腱鞘囊肿平均大小为 1.5 cm×1.5 cm×1.0 cm。组织苏木精-伊红（H&E）染色显示为纤维组织、胶原纤维、黏液样物质和少量成纤维细胞。18 例患者获得 11 个月至 10 年的随访，平均 5.4 年，均未见复发。术后 16 例患者无自觉症状，2 例分别于术后 1 年和 6 个月出现踝关节疼痛。采用美国足踝外科协会（AOFAS）踝-后足评分标准评价疗效：术前踝与后足评分为 78.2±13.7 分，末次随访时为 97.3±4.5 分。
踝部骨内腱鞘囊肿无论是否有临床症状，均应行囊肿刮除，骨腔填充植骨，手术效果满意。
