单纯病灶刮除治疗手部内生软骨瘤的疗效分析

Simple curettage without bone grafting for the treatment of enchondroma of the hand： an outcomes analysis

目的探讨单纯病灶刮除治疗手部内生软骨瘤的临床疗效。方法2004年7月至2009年12月，对13例掌、指骨内生软骨瘤患者，采用单纯病灶刮除术进行治疗。疗效评判为分别测量病灶最大处的骨骼直径、手指主动运动度，以及观察x线片改变。结果术后随访8～37个月，平均21．3个月。所有病灶均有新骨生成及塑形，病灶最大处骨骼直径减小。手部关节功能无显著影响，手指主动运动度无明显改变。影像学结果依据手部内生软骨瘤疗效的Tordai分级，1级占84．6％（11／13），2级占15．4％（2／13），3级为0。术后均未发生病理性骨折，肿瘤无复发。结论单纯病灶刮除治疗手部内生软骨瘤，手术操作简单、创伤小、疗效肯定，是有效的治疗方法。

Objective To evaluate the results of simple curettage without bone grafting in the treatment of enchondroma of the hand. Methods Between July 2004 and December 2009, 13 patients with enchondroma of the hand were treated with simple curettage without bone grafting. Postoperative evaluations included the mmdmtun bone diameter at the lesion site, active range of motion and X-ray changes of the involved fingers. Results All the patients were follow-up for 8 to 37 months, with an average of 21.3 months. New bone formation and remodeling of the lesions were observed in all the patients. The mean diameter of the lesion site bone decreased significantly. There was no impairment of joint function of the involved fingers with unchanged active range of motion. The results of radiographic appearance were assessed by applying Tordai＇ s classification of enchondroma of the hand. The final results were Tordai＇ s group 1 in 11 bones （84.6%） and group 2 in 2 bones （15.4%）. There was no bone classified as group 3. During the follow-up periods, there were no pathological fractures and recurrence. Conclusion Simple curettage without bone grafting is a safe and effective treatment for enchondroma of the hand.