距骨骨软骨瘤——14例病例报道及文献回顾  

Osteochondroma of the talus: A 14-case report with literature review

作　　者：童凯[1] 王翔[2] 钟子毅 谢献进 王钢[1] 

机构地区：[1]南方医科大学南方医院创伤骨科,广州510515 [2]南方医科大学南方医院脊柱骨科,广州510515

出　　处：《中国矫形外科杂志》2018年第5期410-415,共6页Orthopedic Journal of China

摘　　要：[目的]分析距骨骨软骨瘤病变的临床发病特征及治疗。[方法]对2000～2016年本院收治经手术及病理证实的14例距骨骨软骨瘤病例进行回顾性分析,其中男10例,女4例。所有病例由临床、影像、病理结合确诊。并结合文献分析其临床发病特征及影像学特点。[结果]14例距骨骨软骨瘤患者发病年龄6～47岁,平均20.86岁。单发11例,多发3例,复发3例,无恶变病例。左足9例,右足6例,发生于距骨内侧9例,外侧2例,前方3例,后方6例,关节内游离体2例。临床症状主要表现为疼痛,局部肿胀,活动受限,行走困难。[结论]距骨骨软骨瘤病变发病率很低,大多数为良性病变,好发于男性,距骨受累部位内侧多于外侧,后方多于前方。患者症状与肿瘤发病部位有关。距骨骨软骨瘤无症状者可保守治疗。对于有症状者,外科手术切除是一个有效的治疗方式。[Objective] To analyze the pathogenesis feature and treatment of talar osteochondrema. [Methods] From 2000 to 2016, 14 patients with talar osteochondroma surgically treated in our institution were retrospectively analyzed. Of them, 10 males and 4 females were confirmed the definitive diagnosis by combination of clinical, imaging and pathological aspects. More- over, a review of the published studies of talar osteochondroma was conducted to analyze the clinical and imaging features. [Resuits] The 14 patients aged from 6 to 47 years with a mean age of 20.86 years at onset of the disease. Solitary osteochondroma occurred in 11 patents, while multiple osteochondroma in 3 patients, associated with the recurrent lesion in 3 cases of them. However, no malignant transformation happened in any of them. In term of lesion location, 9 patients were involved in the left and 6 in the right foot, including the medial talus affected in 9 patients, the lateral talus in 2, the front talus in 3, and the rear ta- lus in 6 patients, associated with ankle loose body in 2 patients. The main clinical symptoms included pain, local swelling, mo- tion limitation and walking difficulty. [Conclusion] The incidence of osteochondroma of the talus is rather lower, and most of the lesions are benign ones with a male predominance. The lesions more commonly involve in the medial side than the lateral side and the rear than the front of the talus. Clinical presentation is related to the location of tumor. Conservative treatment is proper for asymptomatic patients, while surgical resection is an effective treatment for symptomatic patients.

关 键 词：距骨 骨软骨瘤 骨肿瘤 临床特征 

分 类 号：R738.1[医药卫生—肿瘤]