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一名Brodie脓肿患者在脚踝扭伤后持续疼痛的治疗:病例报告

Treatment of a Brodie's abscess manifesting as persistent pain after a twisting ankle injury: A case report.

作者信息

Alasaad Hakam, Diri Doried, ALSamman Hassan, Ibrahim Jaber

机构信息

Damascus University - Faculty of Medicine, Syrian Arab Republic.

Damascus University - Faculty of Medicine, Syrian Arab Republic.

出版信息

Int J Surg Case Rep. 2024 Jul;120:109865. doi: 10.1016/j.ijscr.2024.109865. Epub 2024 Jun 8.

Abstract

INTRODUCTION

Cystic lesions in long bones are the radiological presentation of various bone pathologies, they can easily be misdiagnosed and thus mistreated; treatment varies from observation to aggressive surgical interventions based on the nature and characteristics of the lesion.

CASE PRESENTATION

A 25-year-old male had a twisting injury to his ankle and his radiographs showed a cystic lesion in the distal tibia that was asymptomatic until he injured his ankle. he had persistent pain since then. and after conservative methods failure, a two-stage surgical intervention was done; first, we curetted the lesion and filled it with antibiotics cement; then the cement was removed with autologous bone grafting. The patient eventually healed and returned to his normal activity level.

DISCUSSION

Brodie's abscess has a similar radiological appearance to other bone neoplasms and tumor-like lesions. Clinically, it is minimally symptomatic, and often initially misdiagnosed; surgical treatment is very effective, but it depends on the size, location, and aggressiveness of the lesion; the goal is to eliminate the infection, refill the residual gap, and restore the normal function, especially in weight-bearing bones.

CONCLUSION

Brodie's abscess is a hideous lesion that is hard to diagnose. It could mimic other tumor-like lesions. However, applying bone cement and a second stage of bone grafting might help maximize the treatment efficiency.

摘要

引言

长骨中的囊性病变是多种骨病理状况的影像学表现,它们很容易被误诊进而得到错误的治疗;治疗方法因病变的性质和特征而异,从观察到积极的手术干预不等。

病例介绍

一名25岁男性脚踝扭伤,其X线片显示胫骨远端有一个囊性病变,在他脚踝受伤之前一直无症状。自那时起他一直持续疼痛。在保守治疗方法失败后,进行了两阶段的手术干预;首先,我们刮除病变并填入抗生素骨水泥;然后取出骨水泥并进行自体骨移植。患者最终痊愈并恢复到正常活动水平。

讨论

布罗迪氏骨脓肿与其他骨肿瘤和肿瘤样病变有相似的影像学表现。临床上,其症状轻微,且常常最初被误诊;手术治疗非常有效,但这取决于病变的大小、位置和侵袭性;目标是消除感染,填充残留间隙,并恢复正常功能,尤其是在负重骨中。

结论

布罗迪氏骨脓肿是一种难以诊断的可怕病变。它可能类似其他肿瘤样病变。然而,应用骨水泥和第二阶段的骨移植可能有助于使治疗效果最大化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6021/11258625/025199cf64d7/gr1.jpg

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