微创伤内窥镜诊治手部内生软骨瘤

Treatment of enchondromas in the hand by minimally invasive endoscopy.

目的 介绍微创伤内窥镜治疗手指骨内生软骨瘤的手术方法和经验。 方法 利用直径2 7mm关节镜、小刮勺、电动刨削器、克氏针 ,在手指及掌骨背部尺桡侧皮肤各 ( 2～ 3 )mm切口 ,骨皮质克氏针钻孔开窗 ,小刮勺刮除骨肿瘤后造成腔隙 ,镜视下刨削器彻底清除肿瘤组织 ,不作骨移植 ,术后不需石膏外固定。 结果 术后随访 ( 6～ 18)个月 ,平均 10 5个月 ,X线片示肿瘤组织被彻底清除 ,可见新生骨形成 ,骨内肿瘤腔隙明显缩小 ,1年时瘤腔基本消失 ,无骨折、复发及其它并发症。 结论 手术方法简单 ,创伤小 ,不需移植骨 ,术后不需外固定 ,镜视下能将肿瘤组织扩大而彻底刮除 ,预防复发。

Objective To introduce the surgical methods and our experience in the treatment of enchondromas in the hand by minimally invasive endoscopic curettage without bone graft. Methods 10 patients with enchondroma in the hand were treated with endoscopy. The incisions were (2～3)mm , then the tumors were cleared without bone graft. Results The 10 patients were followed-up by radiologic examination for an average of 10 5 months(ranging from 6months to 18 months) after operation. X-ray showed the complete cleaning of tumor tissues, the formation of new bones and obvious reduction of bone tumor lacunae. The tumor lacunae almost disappeared one year after operation, and there were no postoperative fractures, recurrences or other complications. Conclusions Endoscopic curttage without bone graft is simple ,safe , effective and minimally invasive treatment of enchondromas in the hand .