Hajialiloo Sami Sam, Toloue Ghamari Babak, Kargar Shooroki Khalil, Mohammadi Aniloo Fateme, Ammar Wael, Rikhtehgar Masih, Mohammadi Mohammad, Dehghani Firoozabadi Seyed Reza, Nahvizadeh Shima
Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Foot Ankle Int. 2025 Jan;46(1):9-16. doi: 10.1177/10711007241287714. Epub 2024 Dec 12.
Treatment of Primary metatarsal aneurysmal bone cyst (ABC) with curettage and bone grafting unfortunately has a high recurrence rate, particularly in short tubular bones. This study presents a 16-year experience treating ABCs in the bones of the foot at an orthopaedic oncology referral center. Treatment involved en bloc resection and reconstruction of the defect with fibular allograft in all cases. Retrospectively collected data were used to document the outcomes.
This retrospective review includes patients with primary metatarsal ABC treated en bloc resection at a single center between 2004 and 2020. Information on the diagnosis, treatment, complications, and outcomes was collected from our database for all eligible patients. Radiologic healing was used as our primary outcome measure. The patient's function was assessed using the Toronto Extremity Salvage Score (TESS) and Musculoskeletal Tumor Society (MSTS) score.
The study included 19 subjects (11 women, 8 men) with a mean age of 18 years (SD 11-35). The average resected length was 4.24 cm (3-6 cm). The mean follow-up time was 79.26 months (28-160 months). The mean TESS score and MSTS were 94.52 and 28.42, respectively. The average healing time was 10.2 weeks. No patient had local recurrence. Arthrodesis was performed in 3 patients because of joint involvement. Repeat surgery was performed for 2 patients, debridement for one because of infection and bone graft for another because of nonunion. One patient had experienced an allograft fracture.
Based on the Enneking classification, our experience has shown that a reasonable surgical approach for primary active and invasive metatarsal ABC is en bloc resection and reconstruction with fibula allograft. This method has a low risk of recurrence and does not result in significant functional impairment.
采用刮除术和植骨术治疗原发性跖骨动脉瘤样骨囊肿（ABC），遗憾的是复发率很高，尤其是在短管状骨中。本研究展示了在一家骨科肿瘤转诊中心治疗足部骨骼ABC的16年经验。所有病例的治疗均包括整块切除并用腓骨同种异体骨重建缺损。通过回顾性收集的数据记录治疗结果。
这项回顾性研究纳入了2004年至2020年间在单一中心接受整块切除治疗的原发性跖骨ABC患者。从我们的数据库中收集了所有符合条件患者的诊断、治疗、并发症和治疗结果等信息。影像学愈合被用作主要结局指标。使用多伦多肢体挽救评分（TESS）和肌肉骨骼肿瘤学会（MSTS）评分评估患者的功能。
该研究纳入了19名受试者（11名女性，8名男性），平均年龄为18岁（标准差11 - 35岁）。平均切除长度为4.24厘米（3 - 6厘米）。平均随访时间为79.26个月（28 - 160个月）。平均TESS评分和MSTS评分分别为94.52和28.42。平均愈合时间为10.2周。无患者出现局部复发。3例患者因关节受累接受了关节融合术。2例患者接受了再次手术，1例因感染进行清创，另1例因骨不连进行植骨。1例患者发生了同种异体骨骨折。
基于恩neking分类，我们的经验表明，对于原发性活跃性和侵袭性跖骨ABC，合理的手术方法是整块切除并用腓骨同种异体骨重建。该方法复发风险低，且不会导致明显的功能障碍。
