Antón Rodrigálvarez L M, Ortega Medina L, Cabadas González M I, Aguilar Rodríguez L
Unidad de Ortopedia Infantil, Hospital Clínico San Carlos, Madrid.
An Esp Pediatr. 1998 Oct;49(4):364-8.
The purpose of this study was to analyze the properties of essential bone cyst of the calcaneus in childhood, as well as its evolution, and differences with regard to adults.
The cases of children with a diagnosis of essential bone cyst of calcaneus in last sixteen years in the pediatric orthopedic unit of San Carlos Clinic have been reviewed. We evaluated the information regarding the clinical history and the radiological and histological date as well as the therapy result with esteroid intracavity therapy and curettage and bone grafting. The radiologic score was done following Södergard criteria and the posttreatment follow-up with Neer's score.
The mean age of the patients was 10.3 years. Two of the patients had recurrent heel pain for more than six months. Treatment consisted in intracavitary esteroid in two cases and curettage and bone grafting in all three cases, in two of the cases because of failure of esteroid therapy and in the other because of an atypical X-ray image. In all cases the histological stady identified the existence of a characteristic membrane conective tissue. The postsurgery follow-up a period of half four years has been satisfactory.
The essential bone cyst of the calcaneous is exceptional localization in children, frequently symptomatic and resistant to the esteroid intracavitaria contrary to what happens with the essential bone cyst of other localizations and with the essential bone cyst of the calcaneus in the adults. The recurrent heel pain and atipical X-ray image are surgery indications.
本研究旨在分析儿童跟骨原发性骨囊肿的特性、演变情况以及与成人的差异。
回顾了过去16年在圣卡洛斯诊所小儿骨科确诊为跟骨原发性骨囊肿的儿童病例。我们评估了有关临床病史、放射学和组织学数据以及类固醇腔内治疗、刮除术和植骨术的治疗结果等信息。放射学评分按照瑟德加德标准进行，治疗后随访采用尼尔评分。
患者的平均年龄为10.3岁。其中两名患者有超过6个月的复发性足跟痛。治疗方法为2例采用腔内类固醇治疗，3例均采用刮除术和植骨术，其中2例是因为类固醇治疗失败，另1例是因为X线影像不典型。所有病例的组织学研究均确定存在特征性的膜性结缔组织。术后四年半的随访情况令人满意。
跟骨原发性骨囊肿在儿童中是一种特殊的病变部位，通常有症状，且与其他部位的原发性骨囊肿以及成人跟骨原发性骨囊肿不同，对类固醇腔内治疗有抵抗性。复发性足跟痛和不典型的X线影像为手术指征。
