【摘要】 目的总结手部动脉瘤样骨囊肿的临床诊治特点。方法回顾2007年4月-2017年4月治疗的3例经手术病理明确诊断为手部动脉瘤样骨囊肿患者。分析其临床症状及体征、X线和MRI的影像学特点、术中瘤状表现、手术处理方式、复发处理特点及术后功能恢复情况等。结果 3例患者术后通过门诊及后期电话随访6~10年,1例术后一年半复发,复发后再行手术治疗,随访9年未见复发。3例患者末次随访采用总主动活动度(TAM)法评定邻近关节的活动度,优2例,良1例。结论手部动脉瘤样骨囊肿临床症状以局部膨胀性改变及疼痛为主,根据临床特征及影像学检查可提高诊断准确率,并通过术中病理检查确诊。术中保留骨支架及克氏针内固定可改善患者手部功能,应用高速磨钻打磨骨腔,可降低其复发率。更多还原

【Abstract】 Objective To summarize the characteristics of clinical diagnosis and treatment of aneurysmal bone cysts. Methods The clinical data of 3 patients with aneurysmal bone cysts of the hand by surgery pathology diagnosis who were adopted from April 2007 and April 2017 were retrospectively analyzed,including the clinical symptoms and signs, X-ray features, intraoperative tumor characteristics, surgical treatment characteristics and processes of recurrence. Results Three patients were followed up 6~10 years through outpatient services and telephones. One case relapsed at one and a half years after operation,followed up for 9 years without any recurrence after the second operation. The total active motion(TAM)were used to assess the adjacent joints’ motion in 3 patients at the end of the follow-up. Two cases was excedent and 1 case was good. Conclusion The clinical symptoms of aneurysmal bone cysts of the hand are local swelling and pain. We can improve accuracy rate of the diagnosis of aneurysmal bone cysts of the hand according to clinical features and imaging examinations, but aneurysmal bone cysts are confirmed by intraoperative pathologic examination. On one hand, we can improve the function of patients’ hands by retaining the bone scaffold and using an internal fixation of the kirschner wire; on the other hand, we can use the high speed grinding drill to reduce the recurrence rate of aneurysmal bone cysts of the hand by polishing bone cavity.更多还原