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同种异体骨打压植骨及辅助钢板固定治疗骨骺-干骺端内生软骨瘤:1例罕见病例报告

Allograft Impaction and Supplementary Plating for the Management of Epi-Metaphyseal Enchondroma: A Rare Case Report.

作者信息

Rajani Amyn M, Rajani Kareena, Mittal Anmol Rs, Shah Urvil A, Rajani Khushi A, Rajani Kashish A

机构信息

Department of Orthopaedic, OAKS Clinic, Mumbai, Maharashtra, India.

Department of Clinical Research, OAKS clinic, Mumbai, Maharashtra, India.

出版信息

J Orthop Case Rep. 2022 Sep;12(9):6-9. doi: 10.13107/jocr.2022.v12.i09.2992.

Abstract

INTRODUCTION

Enchondroma is a common bone tumor; however, its location in the proximal epi-metaphyseal region of the tibia is a rare finding. Its management is complicated by the weight-bearing nature of the site and despite an array of available treatment modalities in the literature, there is no fixed consensus.

CASE REPORT

Through this case, we report a 60-year-old female who was evaluated for bilateral knee osteoarthritis. On plain radiography, a lytic lesion was noted which on CT guided biopsy was confirmed to be an enchondroma of the right proximal tibia. The patient underwent extensive curettage, allograft impaction, and supplementary fixation by a poly ethyl ether ketone plate. Following a period of immobilization, she was able to walk full weight-bearing after 3 weeks of the surgery and carry out her daily activities at 2 months. At 1 year postoperatively, the patient achieved excellent clinical, radiological, and functional outcomes without any complications.

CONCLUSION

Management of an enchondroma in weight-bearing regions of long bones can pose multiple challenges. Timely diagnosis and management by thorough curettage, uncompromised allograft impaction, and supplementary fixation by a PEEK plate give excellent short-term and long-term results.

摘要

引言

内生软骨瘤是一种常见的骨肿瘤;然而,其位于胫骨近端骨骺干骺端区域是一种罕见的情况。该部位的负重特性使治疗变得复杂,尽管文献中有一系列可用的治疗方式,但尚无固定的共识。

病例报告

通过本病例,我们报告了一名60岁女性,她因双侧膝关节骨关节炎接受评估。在X线平片上发现一个溶骨性病变,经CT引导活检证实为右胫骨近端内生软骨瘤。患者接受了广泛的刮除术、同种异体骨嵌压植骨,并使用聚醚醚酮板进行辅助固定。经过一段时间的固定,术后3周她能够完全负重行走,2个月时能够进行日常活动。术后1年,患者取得了良好的临床、影像学和功能结果,无任何并发症。

结论

长骨负重区域内生软骨瘤的治疗可能带来多重挑战。通过彻底刮除、充分的同种异体骨嵌压植骨以及聚醚醚酮板辅助固定进行及时诊断和治疗,可取得良好的短期和长期效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5897/9983407/404e5f4fe3fa/JOCR-12-6-g001.jpg

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