Zhang Yunlong, Zhang Zhichang
Department of Orthopedic Surgery, Shanghai Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.
Bone Rep. 2025 Feb 13;24:101830. doi: 10.1016/j.bonr.2025.101830. eCollection 2025 Mar.
Epithelioid hemangioendothelioma (EHE) is an ultra-rare vascular sarcoma with an extremely low incidence and prevalence, particularly in children. We report the case of a 9-year-old girl diagnosed with EHE. There are limited reconstruction methods available following total talus resection for vascular endothelioma of the talus, and the use of a 3D-printed talus prosthesis in pediatric cases has not been previously documented.
A 9-year-old girl presented to our unit with swelling, pain, and limited mobility of the ankle for one month without an obvious cause. X-ray and CT imaging revealed osteolytic lesions in the talus, which was identified as a low-grade malignant tumor that had nearly completely invaded the talus and was surrounded by immature bone. The American Foot and Ankle Surgery Association (AOFAS) score was 75/100. We performed a total resection of the talus followed by unrestricted talus replacement. Three months post-operation, the child was able to walk unaided. Ankle function was assessed at 6 and 13 months post-surgery, with the AOFAS score improving from 75 to 91, indicating that her functional needs for daily life were largely met.
Following complete excision of the lesion, the immature bone surrounding the talus was successfully preserved using an unrestricted 3D-printed prosthesis during ankle reconstruction. Our patient demonstrated satisfactory ankle function during the 6-month follow-up. This method is both safe and stable, yielding promising results, particularly for juvenile patients.
上皮样血管内皮瘤（EHE）是一种极为罕见的血管肉瘤，发病率和患病率极低，尤其是在儿童中。我们报告一例9岁女孩被诊断为EHE的病例。距骨血管内皮瘤全距骨切除术后可用的重建方法有限，且3D打印距骨假体在儿科病例中的应用此前尚无文献记载。
一名9岁女孩因踝关节肿胀、疼痛和活动受限1个月前来我院就诊，无明显诱因。X线和CT成像显示距骨有溶骨性病变，被确定为低度恶性肿瘤，几乎完全侵犯距骨并被未成熟骨包围。美国足踝外科协会（AOFAS）评分为75/100。我们进行了距骨全切除，随后进行了无限制距骨置换。术后3个月，患儿能够独立行走。在术后6个月和13个月对踝关节功能进行评估，AOFAS评分从75分提高到91分，表明她的日常生活功能需求基本得到满足。
在病变完全切除后，踝关节重建过程中使用无限制3D打印假体成功保留了距骨周围的未成熟骨。我们的患者在6个月随访期间踝关节功能令人满意。这种方法安全稳定，效果良好，尤其适用于青少年患者。
