[Chronic digital wound: epidermoid cyst, osteomyelitis or both? Presentation of two clinical cases and review of the literature].

Acta ortopedica mexicana Pub Date : 2022-11-01
A Portes-Chiva, L Martorell-de Fortuny, A Pardo, E Domínguez, N Ciriaco, A Agustí-Claramunt, D Pérez-Prieto
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Abstract

Introduction: when faced with a chronic digital injury, the differential diagnosis between osteomyelitis or primary tumor is raised. Coexistence between osteomyelitis and epidermoid bone cyst is not uncommon.

Material and methods: in this article, we describe two cases of epidermoid cysts in distal phalanx of the hand associated with osteomyelitis and a review of the literature is presented.

Results: both osteomyelitis and epidermoid bone cyst have been related to the presence of previous trauma at the site of the lesion, nail alterations and chronic phlogotic signs, so it is important to reach a diagnosis of certainty through an anatomopathological study and to perform a good surgical debridement to ensure the healing of both entities.

Conclusions: surgical debridement associated with curettage and filling of the bone defect with bone substitute with antibiotic is a good therapeutic option in the treatment of these lesions.

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[慢性指外伤:表皮样囊肿、骨髓炎或两者兼有?两例临床病例的介绍和文献综述]。
引言:当面对慢性指关节损伤时,骨髓炎和原发性肿瘤之间的鉴别诊断会提高。骨髓炎和表皮样骨囊肿并存并不罕见。材料和方法:在本文中,我们描述了两例手远端指骨表皮样囊肿伴骨髓炎的病例,并对文献进行了回顾。结果:骨髓炎和表皮样骨囊肿都与病变部位先前的创伤、指甲改变和慢性根管炎体征有关,因此,通过解剖病理学研究获得确定性诊断并进行良好的手术清创以确保两种实体的愈合是很重要的。结论:手术清创结合刮除和用抗生素骨替代物填充骨缺损是治疗这些病变的良好选择。
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