Department of Orthopedics Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders; Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing, China.
BMC Surg. 2024 Nov 18;24(1):363. doi: 10.1186/s12893-024-02660-4.
Chondroblastoma (CBL) of the femoral head is a rare disease, typically encountered in the epiphysis of long bones, with its occurrence in the femoral head being particularly uncommon. The unique location and aggressive nature of this tumor pose substantial challenges in its treatment, leading to ongoing controversies regarding the therapeutic approaches. In this study, we introduce a technique of curettage without surgical dislocation as a treatment option for CBL in this challenging location.
A total of 6 children diagnosed with chondroblastoma of the femoral head underwent a surgical procedure consisting of curettage, the application of anhydrous alcohol as an adjuvant therapy, followed by bone grafting. The epiphyseal plate status of the femoral head was classified as open, closing, or closed. To evaluate the children's postoperative functional outcome, the Musculoskeletal Tumour Society (MSTS) scoring system was utilized. Additionally, the Lodwick classification was employed to assess the extent of bone destruction. Furthermore, the kappa coefficient was calculated to quantify the level of inter-observers agreement in assessing the status of the epiphyseal plate.
The epiphyseal plate status was closing in two patients and closed in four patients. According to the Lodwick classification, one patient was classified as IA, one as IB, and four as IC. The mean MSTS score was 28. Notably, one patient developed a femoral neck fracture three months post-curettage.
Curettage without surgical dislocation, combined with the use of anhydrous alcohol as an adjuvant therapy, followed by bone grafting, constitutes an effective treatment technique for femoral head chondroblastoma.
股骨头骺软骨母细胞瘤（CBL）是一种罕见疾病，通常发生在长骨的骺部，而发生在股骨头的情况则非常罕见。由于该肿瘤的位置独特且具有侵袭性，因此在治疗方面存在很大的挑战，这导致了对于治疗方法的持续争议。在本研究中，我们介绍了一种无需外科脱位的刮除术作为治疗这种具有挑战性位置的 CBL 的方法。
共有 6 名被诊断为股骨头骺软骨母细胞瘤的儿童接受了手术治疗，包括刮除术、无水酒精作为辅助治疗，以及植骨术。股骨头骺板的状态被分类为开放、闭合或闭合。为了评估儿童术后的功能结局，使用了肌肉骨骼肿瘤学会（MSTS）评分系统。此外，采用 Lodwick 分类来评估骨破坏的程度。还计算了kappa 系数来量化评估骺板状态的观察者间一致性水平。
骺板状态在 2 名患者中为闭合，在 4 名患者中为闭合。根据 Lodwick 分类，1 名患者为 IA 期，1 名患者为 IB 期，4 名患者为 IC 期。MSTS 评分的平均值为 28。值得注意的是，1 名患者在刮除术后 3 个月发生了股骨颈骨折。
无需外科脱位的刮除术，结合无水酒精作为辅助治疗，以及植骨术，是治疗股骨头骺软骨母细胞瘤的有效方法。
