半皮质切除及异体支架移植治疗胫骨骨干金刚烷瘤

M. N. Karalezli, I. H. Korucu, Oğuzhan Pekince, S. Toker
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摘要

金刚烷瘤是一种原发性低级别恶性骨肿瘤,组织成因不明,是一种罕见的肿瘤,仅占所有原发性骨肿瘤的0.1-0.5%。男性比女性更常见,比例为5:4。广泛肿瘤切除保肢是首选的治疗方法。病例报告:一名24岁女性,主诉疼痛和跛行持续约2年。x线平片示左侧胫骨前皮质骨干处扩张性多囊病变伴骨膜反应。我们使用振荡骨锯进行病变的全切除,保留了前皮质。切除后形成的胫骨缺损用一个14厘米的。用动态加压钢板(DCP)和螺钉固定胫骨的长支撑尸股同种异体移植物。讨论:在金刚烷瘤的手术治疗中,不进行全切除术,保留完整的后皮质,以提高患者的满意度,同时在术后进行骨固定和早期负重。我们相信,在同种异体移植体的适当固定下,该缺损将能够愈合。
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Treatment of Adamantinoma in Tibial Diaphysis by Hemicortical Resection and Strut Allograft
Introduction: Adamantinoma is a primary low-grade, malignant bone tumor, of unknown histogenesis which is a rare neoplasm, comprise only 0.1–0.5% of all primary bonetumors. It is slightly more common in men than women, with a ratio of 5:4. Wide tumour resection and limb salvage is the treatment of choice. Case report: A 24 year female reffered with chief complaints of pain and limping lasting for approximately 2 years. Plain X-ray showed an expansile multicystic lesion at the diaphysis of the left tibia anterior cortex with periosteal reaction . We used an oscillating bone saw to perform a total resection of the lesion preserving the anterior cortex. Tibial defect created with this resection was replaced with a 14 cm. long strut cadaveric femoral allograft that fixed to tibia with a dynamic commpresive plate (DCP) and screws. Discussion: In surgical treatment of Adamantinoma, total resection was not performed and remain intact posterior cortex to increased the patient satisfaction, at the same time, bone fixation and early weight bearing at the postoperative. We believe that the defect will be able to union with appropriate fixation of the allograft also be long size.
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