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手部短管状骨孤立性软骨瘤的单纯刮除及同种异体松质骨骨屑嵌压植骨术。

Simple curettage and allogeneic cancellous bone chip impaction grafting in solitary enchondroma of the short tubular bones of the hand.

机构信息

Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Orthopedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-Daero, Paldal-Gu, Suwon-Si, Gyeonggi-Do, 16247, Republic of Korea.

出版信息

Sci Rep. 2023 Feb 6;13(1):2081. doi: 10.1038/s41598-023-29130-w.

Abstract

Enchondroma is the most common bone tumor in the hand. While standard surgical procedure is intra-lesional excision and bone grafting, there is a dispute between allogeneic bone, autogenous bone, and synthetic bone substitute grafting. Diverse adjuvant treatments have been introduced to reduce recurrence, but results are mixed with controversies. Meanwhile, whether existing descriptive classification could predict treatment outcome remains unclear. Thus, we reviewed patients with solitary enchondroma of the hand who underwent simple curettage followed by allogeneic cancellous bone chip impaction grafting. Eighty-eight patients with more than 5 years of follow-up were enrolled. Demographic data, local recurrence, and complications were reviewed. Duration of consolidation and the difference according to Takigawa classification were assessed. Range of motion (ROM), and functional scores were also evaluated. There were 51 women and 37 men, with a mean age of 37.9 years. Mean follow-up was 10.2 years. Recurrence occurred only in one patient. There was no complication. Mean postoperative total active motions of fingers and thumb were 239° and 132.9°. Mean modified Disabilities of the Arm, Shoulder, Hand score, and Musculoskeletal Tumor Society Score were 1.63, and 99.2 at the last follow-up. Consolidation, ROM, and functional scores according to Takigawa classification showed no significant differences. This study suggests that simple curettage with impaction grafting of allogeneic cancellous bone chip is a feasible method for treating solitary enchondromas involving short tubular bone of the hand with good long-term outcomes. Postoperative recurrence and complication rates were very low. Radiographic and clinical results were good regardless of the previous radiological classification.

摘要

内生软骨瘤是手部最常见的骨肿瘤。标准的手术方法是病灶内切除和植骨,但异体骨、自体骨和合成骨替代物移植存在争议。已经引入了多种辅助治疗方法来降低复发率,但结果存在争议。同时,现有的描述性分类是否能预测治疗效果尚不清楚。因此,我们回顾了手部单纯内生软骨瘤患者,他们接受了单纯刮除术,然后进行同种异体松质骨骨屑嵌压植骨。共纳入 88 例随访时间超过 5 年的患者。回顾了患者的人口统计学数据、局部复发和并发症情况。评估了骨愈合时间和根据 Takigawa 分类的差异。还评估了关节活动度(ROM)和功能评分。患者中 51 例为女性,37 例为男性,平均年龄为 37.9 岁。平均随访时间为 10.2 年。仅 1 例患者复发。无并发症。术后手指和拇指总主动活动度的平均值分别为 239°和 132.9°。末次随访时平均改良的上肢功能障碍评分(DASH)和肌肉骨骼肿瘤学会评分(MSTS)分别为 1.63 和 99.2。根据 Takigawa 分类,骨愈合、ROM 和功能评分无显著差异。本研究表明,单纯刮除术联合同种异体松质骨骨屑嵌压植骨是治疗手部短管状骨内生软骨瘤的一种可行方法,具有良好的长期疗效。术后复发率和并发症发生率非常低。无论先前的影像学分类如何,影像学和临床结果都很好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08d7/9902569/bab3a84a1b51/41598_2023_29130_Fig1_HTML.jpg

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